Department of Anesthesiology & Pain Medicine, Anesthesia & Pain Research Institute, Yonsei University College of Medicine, 250 Seongsan-ro, Seodaemun-gu, Seoul 120-752, Korea.
Yonsei Med J. 2010 May;51(3):475-7. doi: 10.3349/ymj.2010.51.3.475.
A patient received combined spinal-epidural anesthesia for a scheduled total knee arthroplasty. After an injection of spinal anesthetic and ephedrine due to a decrease in blood pressure, the patient developed a severe headache. The patient did not respond to verbal command at the completion of the operation. A brain CT scan revealed massive subarachnoid and intraventricular hemorrhages, and a CT angiogram showed a ruptured aneurysm. Severe headaches should not be overlooked in an uncontrolled hypertensive patient during spinal anesthesia because it may imply an intracranial and intraventricular hemorrhage due to the rupture of a hidden aneurysm.
一位患者因计划行全膝关节置换术而接受了脊麻-硬膜外联合麻醉。在血压下降后，给予了脊髓麻醉和麻黄碱，此后患者出现严重头痛。术毕患者对言语指令无反应。颅脑 CT 扫描显示大量蛛网膜下腔和脑室出血，CT 血管造影显示破裂的动脉瘤。在接受脊髓麻醉的未控制高血压患者中，严重头痛不应被忽视，因为这可能意味着由于隐匿性动脉瘤破裂而导致颅内和脑室内出血。
