产时气颅导致的急性起病头痛，为分娩硬膜外麻醉的并发症。
Acute onset headache complicating labor epidural caused by intrapartum pneumocephalus.
作者信息
Smarkusky Loren, DeCarvalho Helena, Bermudez Ady, González-Quintero Víctor Hugo
机构信息
Department of Obstetrics, Division of Maternal Fetal Medicine and Anesthesia, University of Miami School of Medicine/Jackson Memorial Hospital, Miami, FL 33101, USA.
出版信息
Obstet Gynecol. 2006 Sep;108(3 Pt 2):795-8. doi: 10.1097/01.AOG.0000209185.54752.48.
BACKGROUND
Epidural placement for obstetric anesthesia is a common procedure. Pneumocephalus, the introduction of air into the cranial cavity after epidural placement, is a rare complication encountered when air is used for identification of the epidural space.
CASE
A 42-year-old primipara undergoing epidural placement reported sudden onset of severe headache with associated neurologic symptoms and nuchal rigidity. Emergent CT scan revealed pneumocephalus. With conservative management, her symptoms resolved with interval resumption of the air collection evidenced on interval CT.
CONCLUSION
Acute onset headache after epidural placement can present with impressive neurologic signs and symptoms. Prompt identification of the cause of this pathology is of vital importance to delineate pneumocephalus from potentially treatable or life-threatening disorders.
背景
硬膜外麻醉用于产科麻醉是一种常见的操作。气颅是硬膜外穿刺后置入空气进入颅腔导致的，是在使用空气来确定硬膜外间隙时遇到的一种罕见并发症。
病例
一名42岁初产妇在进行硬膜外穿刺时报告突然出现严重头痛，并伴有神经症状和颈部僵硬。急诊CT扫描显示气颅。经保守治疗，她的症状得到缓解，后续CT显示气颅情况有所恢复。
结论
硬膜外穿刺后急性发作的头痛可能伴有明显的神经体征和症状。迅速识别这种病理状况的病因对于区分气颅与潜在可治疗或危及生命的疾病至关重要。
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