Kato Takahiro, Nakagawa Itsuo, Hidaka Shozo, Okada Yasunori, Kubo Takashi, Okamura Kenta
Department of Anesthesia, Chugoku Rosai General Hospital, Kure.
Masui. 2007 Apr;56(4):436-8.
We experienced a case of spontaneous intracranial hypotension (SIH) complicated with depressed consciousness after its treatment. A 56-year-old woman developed postural headache, and her MRI revealed bilateral chronic subdural hematoma (CSH). After treatment with epidural autolongous blood patch, her headache resolved completely. However, two days after, the patient developed depressed conciousness, and MRI showed brain sagging and downward brain displacement. After management with conservative treatment, including second epidural blood patch and hematoma drainage, the patient became alert and other symptoms resolved gradually. We demonstrated that caution should be taken for the management of SIH, especially in the case associated with CSH.
我们遇到了一例自发性颅内低压(SIH)患者,其在治疗后出现意识障碍。一名56岁女性出现体位性头痛,其MRI显示双侧慢性硬膜下血肿(CSH)。经硬膜外自体血补片治疗后,她的头痛完全缓解。然而,两天后,患者出现意识障碍,MRI显示脑下垂和脑向下移位。经过包括第二次硬膜外血补片和血肿引流在内的保守治疗后,患者变得清醒,其他症状逐渐缓解。我们证明,对于SIH的治疗应谨慎,尤其是在与CSH相关的病例中。