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脊髓麻醉并发颅内硬膜下血肿的非手术治疗

Non-surgical management of intracranial subdural hematoma complicating spinal anesthesia.

作者信息

Verdu M T, Martínez-Lage J F, Alonso B, Sánchez-Ortega J L, Garcia-Candel A

机构信息

Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.

出版信息

Neurocirugia (Astur). 2007 Feb;18(1):40-3.

Abstract

We report the case of a 29 year-old woman who presented a symptomatic intracranial subdural hematoma developing shortly after spinal anesthesia. The patient was fully conscious at clinical onset, and thus we treated her conservatively with an epidural autologous blood patch and close neurological observation. Given the clinical improvement the possibility of surgery was discauded in agreement with the neurosurgical team. Most cases of subdural hematoma appearing after spinal anesthesia are treated with surgery. In the present case the subdural hemorrhage was detected at our hospital 20 days after the anesthetic procedure, and given the excellent state of consciousness, we choosed a conservative management.

摘要

我们报告了一例29岁女性病例,该患者在脊髓麻醉后不久出现有症状的颅内硬膜下血肿。临床发病时患者意识完全清醒,因此我们采用硬膜外自体血贴片并密切进行神经学观察对其进行保守治疗。鉴于临床症状改善,经与神经外科团队协商,排除了手术的可能性。大多数脊髓麻醉后出现的硬膜下血肿病例采用手术治疗。在本病例中,硬膜下出血在麻醉操作后20天于我院被发现,鉴于患者意识状态良好,我们选择了保守治疗。

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