Sharma S, Halliwell R, Dexter M, Mudaliar Y, Yee K
Department of Anaesthesia, Westmead Hospital, Sydney, New South Wales, Australia.
Anaesth Intensive Care. 2010 Sep;38(5):939-41. doi: 10.1177/0310057X1003800521.
A 31-year-old term primigravid woman had an intrathecal catheter placed following a dural puncture during attempted epidural analgesia during labour. After 23 hours she developed sudden loss of consciousness and an urgent brain computed tomography scan demonstrated a large left hyper-acute subdural haematoma. Craniotomy revealed active bleeding from a ruptured left temporal bridging vein. She was extubated 12 hours after surgery and was discharged home 11 days later without neurological deficit. Although subdural haematoma is a recognised complication of dural puncture, it has not been reported in the presence of an intrathecal catheter. An intrathecal catheter may not always prevent cerebrospinal fluid efflux, so subdural haematoma remains a potential complication of inadvertent dural puncture.
一名31岁的足月初产妇在分娩时硬膜外镇痛尝试过程中硬膜穿刺后放置了鞘内导管。23小时后，她突然意识丧失，紧急脑部计算机断层扫描显示左侧有一个巨大的超急性硬膜下血肿。开颅手术发现左侧颞叶桥静脉破裂并伴有活动性出血。术后12小时她拔除气管插管，11天后出院，无神经功能缺损。虽然硬膜下血肿是硬膜穿刺公认的并发症，但在存在鞘内导管的情况下尚未见报道。鞘内导管不一定总能防止脑脊液外流，因此硬膜下血肿仍然是意外硬膜穿刺的潜在并发症。
