Reina M A, López A, Benito-León J, Pulido P, María F
Servicio de Anestesiología del Hospital de Móstoles, Madrid.
Rev Esp Anestesiol Reanim. 2004 Jan;51(1):28-39.
Subdural and epidural hematomas complicating central blocks are rare but serious complications that can lead to permanent neurological deficits. This review discusses cranial and spinal subdural hematomas, including the history of this complication in the literature. Theories to explain the mechanisms by which hematomas are formed are presented and risk factors are analyzed. The associations between such hematomas and the design of the various needles used for lumbar puncture are evaluated and the most common cranial and spinal locations are discussed. The anatomy of tissues that envelop and contain chronic subdural hematomas are described and the various neurological alterations that can develop are mentioned. Finally, diagnostic imaging options and corrective surgical techniques are reviewed.
硬膜下和硬膜外血肿作为中枢神经阻滞的并发症虽罕见但严重,可导致永久性神经功能缺损。本综述讨论了颅内和脊髓硬膜下血肿,包括该并发症在文献中的历史。提出了解释血肿形成机制的理论并分析了危险因素。评估了此类血肿与用于腰椎穿刺的各种针头设计之间的关联,并讨论了最常见的颅内和脊髓部位。描述了包裹和包含慢性硬膜下血肿的组织解剖结构,并提及了可能出现的各种神经学改变。最后,回顾了诊断成像选项和矫正手术技术。