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April 20, 2026Nosotchu0 citationsOpen Access

A Case of Hematoma Removal for Spinal Subarachnoid Hemorrhage Associated with Eosinophilic Granulomatosis with Polyangiitis

HSHiroaki SagoTKTeppei KawabataTNTomoyuki Noda

Key Points

  • To report a case of spinal subarachnoid hemorrhage associated with eosinophilic granulomatosis with polyangiitis and its management.
  • Performed hematoma removal surgery on a 71-year-old male with cervical spinal SAH.
  • Diagnosed eosinophilic granulomatosis with polyangiitis through skin biopsy and clinical history.
  • Administered steroid treatment to stabilize the condition.
  • Surgical intervention helped prevent progression of paralysis.
  • Histological examination of the hematoma showed eosinophil-dominant inflammation.
  • Early diagnosis and treatment of EGPA were emphasized as critical.

Abstract

好酸球性多発血管炎性肉芽腫症(eosinophilic granulomatosis with polyangiitis: EGPA)に合併した脊髄くも膜下出血(spinal SAH: sSAH)に対し血腫除去術を行った一例を報告する.71歳男性,四肢麻痺で発症した頚椎レベルのsSAHに対し血腫除去を行い麻痺の進行を防いだ.既往症の気管支喘息およびアレルギー性鼻炎や末梢血好酸球増多,anti-neutrophil cytoplasmic antibody(ANCA)陽性から,EGPAを疑い皮膚生検にて確定診断に至り,ステロイド投与で病勢は鎮静化した.摘出した血腫中に好酸球優位の炎症像を認めEGPAがsSAHの原因と考えられた.EGPAは早期診断,治療が重要となる全身性の疾患で,sSAHは極めて稀な合併症である.sSAHを契機に診断に至ることがあり,既往症や好酸球増多からEGPAを鑑別に挙げることが重要である.また,sSAHに対して迅速な外科的介入が有用な可能性がある.

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Cite This Study

Sago et al. (2026) studied this question.

synapsesocial.com/papers/69e5c2d003c2939914028bfehttps://doi.org/10.3995/jstroke.11389
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