Monsma M, Gallego J, Lorente P, Estévez A, Villalaín C, Bustos M
Servicio de Anestesiología-Reanimación, Pabellón Maternal, Hospital Universitario La Fe de Valencia.
Rev Esp Anestesiol Reanim. 2003 Jan;50(1):42-5.
A 29-year-old woman presented projectile vomiting followed by frontal headache, immediately upon receiving epidural analgesia for labor. The clinical picture persisted until expulsion. Although no leaking of spinal fluid into the needle or epidural catheter had been observed, post-dural puncture headache was diagnosed. The postpartum persistence of symptoms and the patient's generally worsening condition indicated the need for more thorough physical examination, which revealed signs of neurological involvement. Those findings and imaging studies (computed tomography of the brain, transcranial Doppler and magnetic resonance angiography) established a final diagnosis of postpartum cerebral angiopathy. Although epidural analgesia is increasingly requested by women entering labor, it is not a risk-free procedure. We describe a relatively unknown clinical entity, postpartum cerebral angiopathy, that developed during epidural analgesia for labor and that was initially believed to be a complication of the analgesic technique.
一名29岁女性在分娩时接受硬膜外镇痛后，立即出现喷射性呕吐，随后出现前额头痛。这种临床表现一直持续到分娩结束。尽管未观察到脑脊液漏入穿刺针或硬膜外导管，但仍诊断为硬膜穿刺后头痛。产后症状持续存在且患者总体病情不断恶化，这表明需要进行更全面的体格检查，检查发现了神经受累的迹象。这些发现以及影像学检查（脑部计算机断层扫描、经颅多普勒和磁共振血管造影）最终确诊为产后脑血管病。尽管越来越多进入分娩期的女性要求进行硬膜外镇痛，但这并非无风险的操作。我们描述了一种相对不为人知的临床病症——产后脑血管病，它在分娩硬膜外镇痛期间发生，最初被认为是镇痛技术的一种并发症。
