Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of hematomyelia caused by coagulation -fibrinolysis abnormality accompanied with colon cancer and its metastasis

Yoshitake Abe, M.D., Yusuke Hazama, M.D., Takuya Hanaoka, M.D., Noriyuki Kimura, M.D., Ryuki Arakawa, M.D. and Toshihide Kumamoto, M.D.

From the Department of Neurology and Neuromuscular Disorders, Oita University Faculty of Medicine

A 76-year-old woman developed weakness and sensory loss in the lower limbs and urinary disturbance in four days. She had a history of operation for the ascending colon cancer and lung metastasis one year ago. Neurological examination revealed flaccid paraplegia, absent Achilles tendon reflex, severe disturbance of superficial and deep sensation below the L3 level, and vesicorectal abnormality. Magnetic resonance imaging (MRI) studies showed an intramedullary T1-iso, T2-low lesion with Gd-DTPA contrast enhancement in conus medullaris at LI level. The laboratory examination revealed the elevated level of serum FDP, D-dimer and TAT. She was diagnosed as hematomyelia, which may be caused by the activation of coagulation and fibrinolysis system. We suggested that the ascending colon cancer and lung metastasis may contribute to the coagulation-fibrinolysis abnormality.
Full Text of this Article in Japanese PDF (658K)

(CLINICA NEUROL, 48: 263|266, 2008)
key words: conus medullaris, hematomyelia, coagulopathy, abnormal fibrinolysis, colon cancer

(Received: 5-Oct-07)