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

:由于缺乏客观的手术数据,在大多数中枢神经系统浅表铁屑病患者中,确切的出血来源仍然未知。本文作者描述了一个58岁的中枢神经系统表皮异位症的病例。由于脊柱硬膜缺损,患者也有脊柱CSF漏出。使用后路椎板成形术和硬膜外方法经硬膜外固定术修复硬脑膜缺损。在修复手术期间,发现出血源是缺损周围的硬膜外静脉。本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CNS浅表铁定病并发CSF渗漏的患者的慢性出血源。硬膜外修补手术可能会导致CSF泄漏中断,硬膜外CSF收集消退以及停止慢性硬膜外出血。

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