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脊髓麻醉后颅内硬膜下血肿:病例报告及文献综述

Intracranial subdural hematoma following spinal anesthesia: case report and review of the literature.

作者信息

Machurot P Y, Vergnion M, Fraipont V, Bonhomme V, Damas F

机构信息

Emergency Department, Centre Hospitalier Réegional de la Citadelle, 4000 Liège, Belgique.

出版信息

Acta Anaesthesiol Belg. 2010;61(2):63-6.

Abstract

Postdural puncture headaches represent one of the main complications of spinal anesthesia. Sometimes, they can reveal the presence of an intracerebral hemorrhage or intracranial subdural hematoma. Atypical postdural puncture headaches or secondary alterations of a typical headache, and particularly the disappearance of its postural character, must prompt to search for another cause. Early diagnosis and careful and rapid management are mandatory. We here report the case of a 53-year-old woman who presented with an intracranial subdural hematoma following spinal anesthesia for hallux valgus surgery performed 48 hours earlier. The implications of such a diagnosis are then discussed, in the light of the existing literature.

摘要

硬膜穿刺后头痛是脊髓麻醉的主要并发症之一。有时,它们可能提示存在脑出血或颅内硬膜下血肿。非典型的硬膜穿刺后头痛或典型头痛的继发性改变,尤其是其姿势性特征的消失,必须促使寻找其他病因。早期诊断以及仔细、迅速的处理是必不可少的。我们在此报告一例53岁女性的病例,该患者在48小时前因拇外翻手术接受脊髓麻醉后出现颅内硬膜下血肿。然后根据现有文献讨论这种诊断的意义。

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