Yatziv Yossi, Stolowitch Chaim, Segev Yoram, Kesler Anat
Department of Ophthalmology, Tel Aviv Sourasky Medical Center,Tel Aviv University, Tel Aviv, Israel.
Obstet Gynecol. 2008 Feb;111(2 Pt 2):540-1. doi: 10.1097/01.AOG.0000285481.99887.88.
Cranial nerve palsy after dural puncture is an uncommon complication. The sixth cranial nerve is the most commonly affected because of its long intracranial course. We report a case of acute comitant esotropia that occurred after unintentional dural puncture.
A young woman presented with acute onset comitant esotropia 1 week after epidural anesthesia for a normal vaginal delivery during which the dura was unintentionally punctured. Magnetic resonance imaging revealed diffuse pachymeningeal enhancement, typically seen after dural puncture. Resolution was spontaneous.
Puncture of the dura should be considered when acute strabismus is diagnosed shortly after epidural anesthesia.
硬膜穿刺后出现颅神经麻痹是一种罕见的并发症。第六颅神经因其在颅内走行长而最常受累。我们报告一例意外硬膜穿刺后发生急性共同性内斜视的病例。
一名年轻女性在正常阴道分娩硬膜外麻醉期间意外硬膜穿刺后1周出现急性起病的共同性内斜视。磁共振成像显示弥漫性硬脑膜强化，这在硬膜穿刺后常见。斜视自行缓解。
硬膜外麻醉后不久诊断为急性斜视时应考虑硬膜穿刺。
