In most patients with superficial siderosis of the CNS, the exact source of bleeding remains unknown because of a lack of objective surgical data. The authors herein describe the case of a 58-year-old man with superficial siderosis of the CNS. The patient also had spinal CSF leakage due to a spinal dural defect. Repair surgery for the dural defect was performed using posterior laminoplasty with a transdural approach without spinal fixation. During repair surgery, the bleeding source was found to be the epidural vein around the defect. The intraoperative and histological results of the present case suggest that epidural veins exposed to CSF represent a chronic bleeding source in patients with superficial siderosis of the CNS complicated by CSF leakage. Dural repair surgery may result in discontinuation of the CSF leaks, resolution of the epidural CSF collection, and cessation of chronic epidural bleeding.

译文

在大多数中枢神经系统浅表铁皮病患者中,由于缺乏客观的手术资料,出血的确切来源仍然未知。本文的作者描述了一名58岁的患有中枢神经系统浅表铁皮病的男子的情况。该患者还因硬脊膜缺损而出现脊髓CSF渗漏。硬脑膜缺损的修复手术是使用后路椎板成形术和经硬脑膜入路而不进行脊柱固定的。在修复手术中,发现出血源是缺损周围的硬膜外静脉。本病例的术中和组织学结果表明,暴露于CSF的硬膜外静脉代表了中枢神经系统浅表铁皮沉着症并伴有CSF渗漏的患者的慢性出血源。硬脑膜修复手术可能导致CSF泄漏的中断,硬膜外CSF收集的消退以及慢性硬膜外出血的停止。

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