Sethi Divya, Gupta Madhu, Sood Suvidha
Department of Anaesthesia and Intensive Care, Employees' State Insurance Postgraduate Institute of Medical Sciences and Research (ESIC PGIMSR), Basaidarapur, New Delhi, India.
Indian J Anaesth. 2011 Jul;55(4):375-7. doi: 10.4103/0019-5049.84864.
A 14-year-old boy underwent emergency debridement surgery of right foot under spinal anaesthesia. Four hours after the surgery, the patient developed symptoms of cauda equina syndrome (CES). Postoperative magnetic resonance imaging of the patient's spine suggested underlying tubercular arachnoiditis. The boy was started on intravenous methylprednisolone and antitubercular therapy. He responded to the therapy and recovered completely in 2 weeks without any residual neurological deficits. We suggest that underlying pathological changes in the subarachnoid space due to tubercular arachnoiditis contributed to maldistribution of the local anaesthetic drug leading to CES.
一名14岁男孩在脊髓麻醉下接受了右脚紧急清创手术。术后4小时，患者出现马尾综合征（CES）症状。患者脊柱的术后磁共振成像显示存在潜在的结核性蛛网膜炎。该男孩开始接受静脉注射甲泼尼龙和抗结核治疗。他对治疗有反应，并在2周内完全康复，没有任何残留神经功能缺损。我们认为，结核性蛛网膜炎导致的蛛网膜下腔潜在病理变化导致局部麻醉药物分布不均，从而引发了马尾综合征。
