Ozdemir Ozgur, Calisaneller Tarkan, Yildirim Erkan, Altinors Nur
Department of Neurosurgery, Baskent University Faculty of Medicine, Ankara, Turkey.
J Manipulative Physiol Ther. 2007 Sep;30(7):536-8. doi: 10.1016/j.jmpt.2007.07.005.
Conservative treatment of lumbar radiculopathy includes bed rest, oral medications, physical therapy, spinal manipulation, mobilization, and epidural steroid injections. Intracranial subdural hematoma after accidental dural puncture is a rare and life-threatening complication of epidural steroid injections. In this report, we present a case of subacute intracranial subdural hematoma that developed after epidural steroid injection.
A 40-year-old man was admitted to our clinic with severe persistent headache and vomiting for 2 days after epidural steroid injection for right leg pain.
The patient was hospitalized for epidural steroid injection for right leg pain in our pain clinic and was discharged the same day. Twenty-four hours later, he started having a headache. Despite the use of oral analgesics, his headache worsened, and he began to vomit particularly in the upright position. Magnetic resonance imaging of the brain displayed a right frontal subdural hematoma. The headache was relieved after strict bed rest, intravenous hydration, and analgesics. The patient was discharged with full recovery after 1 week.
Intracranial subdural hematoma after accidental dural puncture during epidural steroid injection is a rare complication. Persistent headache should be evaluated carefully for possible intracranial hematomas.
腰椎神经根病的保守治疗包括卧床休息、口服药物、物理治疗、脊柱推拿、松动术以及硬膜外类固醇注射。硬膜外类固醇注射后意外硬膜穿刺导致颅内硬膜下血肿是一种罕见且危及生命的并发症。在本报告中，我们呈现一例硬膜外类固醇注射后发生的亚急性颅内硬膜下血肿病例。
一名40岁男性因右腿疼痛接受硬膜外类固醇注射后，出现严重持续性头痛和呕吐2天，入住我院门诊。
该患者在我院疼痛门诊因右腿疼痛接受硬膜外类固醇注射后当日出院。24小时后，他开始出现头痛。尽管使用了口服镇痛药，但其头痛仍加重，并且尤其在直立位时开始呕吐。脑部磁共振成像显示右侧额叶硬膜下血肿。经过严格卧床休息、静脉补液和使用镇痛药后，头痛缓解。1周后患者完全康复出院。
硬膜外类固醇注射过程中意外硬膜穿刺后发生颅内硬膜下血肿是一种罕见的并发症。对于持续性头痛应仔细评估是否存在颅内血肿。
