New York Medical College, Metropolitan Hospital Center, Department of Emergency Medicine, New York, New York.
West J Emerg Med. 2012 Feb;13(1):108-10. doi: 10.5811/westjem.2011.8.6872.
Subdural hematoma (SDH) is a rare, but life-threatening complication of spinal anesthesia. Subdural hematoma resulting from this procedure could present with vague symptoms such as chronic headache and could easily be missed. Chronic headache is one of the symptoms of chronic SDH in postpartum women. Diplopia as the presenting complaint in SDH secondary to peripartum spinal anesthesia has not, to our knowledge, been previously reported. Here, we report a case of diplopia secondary to postpartum subacute bilateral SDHs with transtentorial herniation after spinal anesthesia in a healthy primagravid 25-year-old woman. SDH can expand gradually and the initial symptoms might be subtle as in our case, despite critically high intracranial pressure.
硬脑膜下血肿(SDH)是一种罕见但危及生命的脊髓麻醉并发症。这种手术引起的硬脑膜下血肿可能表现为慢性头痛等模糊症状,很容易被忽视。慢性头痛是产后妇女慢性 SDH 的症状之一。据我们所知,在围产期脊髓麻醉后出现的 SDH 中,以复视为首发症状的情况尚未有报道。在这里,我们报告了一例 25 岁初产妇在脊髓麻醉后发生双侧亚急性 SDH 伴天幕疝的病例,患者出现复视。尽管颅内压极高,但 SDH 可能会逐渐扩大,初始症状可能像我们的病例一样轻微。