Hemorrhagic Diseases of the Spinal Cord

　　The etiology of this disease is unknown, including various clinical syndromes such as post-infection spinal inflammation and post-vaccination spinal inflammation, demyelinating spinal inflammation (acute disseminated encephalomyelitis), necrotizing spinal inflammation, and paraneoplastic spinal inflammation. Most patients have symptoms of upper respiratory tract infection, fever, diarrhea, and other viral infection symptoms 1-4 weeks before the onset of spinal cord symptoms, but antibodies were not detected in the cerebrospinal fluid, and viruses were not isolated from the spinal cord and cerebrospinal fluid, which may be related to allergic reactions after viral infection and is not caused by direct infection, so it is a non-infectious inflammatory type of spinal inflammation.

　　Hemorrhagic spinal cord diseases mainly manifest as epidural, subdural, and intramedullary hemorrhages, with complications including symptoms of trauma and secondary pneumonia, bedsores, urinary tract infections caused by bedridden paraplegia.

　　Hemorrhagic spinal cord diseases are characterized by epidural, subdural, and intramedullary hemorrhages, which can suddenly cause severe back pain, paraplegia, sphincter dysfunction, and symptoms of lesion loss, presenting acute transverse myelitis; subdural hematoma is less common than epidural hematoma; subarachnoid hemorrhage from spinal surface vessels can cause sudden neck and back pain, meningeal irritation signs, and paraplegia, with back pain only if the hemorrhage is caused by the rupture of spinal surface vessels without signs of spinal cord compression.

　　The etiology of this disease is complex, and there is no effective preventive method. To prevent hemorrhagic spinal cord diseases caused by trauma, attention should be paid to safe production, sports safety, and preventing trauma, especially the elderly should pay special attention to safety when going out.

　　The clinical examination of hemorrhagic spinal cord diseases includes the following items:

　　1. Electrophysiological examination
　　Visual evoked potential (VEP) is normal, which can differentiate it from optic neuritis and MS; the amplitude of somatosensory evoked potential (SEP) in the lower limbs can significantly decrease; motor evoked potential (MEP) is abnormal, which can be used as an indicator of treatment efficacy and prognosis; electromyography shows denervation changes.

　　2. Lumbar puncture
　　The cervical compression test is unobstructed, and in a few cases, severe spinal cord edema may lead to incomplete obstruction. CSF pressure is normal, with a colorless and transparent appearance, normal or slightly elevated cell count and protein content, mainly lymphocytes, with normal glucose and chloride levels.

　　3. Imaging Examination
　　The X-ray film of the spine is normal. The MRI shows that the spinal cord at the site of the lesion is thickened, with multiple patchy or dot-like foci in the spinal cord segments, showing T1 low signal and T2 high signal, uneven intensity, and may fuse. Some cases may be abnormal throughout.

　　The diet of patients with hemorrhagic diseases of the spinal cord should be light and avoid spicy and other irritant foods. The following are recommended for therapeutic diet:
　　Peanut Soup:200 grams of peeled peanuts, with 500 grams of pork rib with meat or pork liver, cook into soup for eating.
　　Silver Ear Porridge:Wash and soak silver ear 10 grams for 4 hours, add 100 grams of glutinous rice and 10 dates to the pot first, then add silver ear and appropriate amount of sugar when the water boils, and cook into porridge. The method of eating is the same as above.
　　Two Fresh Drinks:Chopped Dendrobium stem 150 grams, sliced lotus root 200 grams, boiled into juice for drinking.

　　There is no specific treatment for this disease. The treatment principle is mainly aimed at the symptoms, including reducing spinal cord damage, preventing complications, and promoting functional recovery.
　　1. Drug Treatment: UseCorticosteroid hormones, immunoglobulins, antibiotics, vitamin B complex, and other drugs are helpful for the recovery of neurological function.
　　2. Maintain respiratory通畅:Acute ascending myelitis and high cervical myelitis can cause respiratory muscle paralysis. For mild respiratory distress, use expectorants and ultrasonic atomization inhalation. For severe respiratory distress, clear respiratory secretions in a timely manner to keep the airway open; if necessary, perform tracheotomy and use an artificial respirator to maintain breathing.
　　3. Prevention of Complications:Turn over, pat the back to prevent atelectasis, keep the paralyzed limb in a functional position; place an air ring at the bony prominence, massage the skin, and move the paralyzed limb; gently rub the skin with 70% alcohol if it turns red, apply 3.5% benzoin tincture, change the local dressing for bedsores, and strengthen nutrition; avoid using a hot water bag to prevent burns; for urinary obstruction, perform indwelling catheterization to prevent urinary tract infection; for dysphagia, place a gastric tube.
　　4. Early Rehabilitation Training:Helpful for functional recovery and improvement of prognosis.