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硬膜下血肿:电休克治疗的不良事件——病例报告及文献综述

Subdural hematoma: an adverse event of electroconvulsive therapy-case report and literature review.

作者信息

Kulkarni Ranganath R, Melkundi Sateesh

机构信息

Department of Psychiatry, SDM College of Medical Sciences and Hospital, Karnataka, Dharwad 580009, India.

出版信息

Case Rep Psychiatry. 2012;2012:585303. doi: 10.1155/2012/585303. Epub 2012 Nov 14.

DOI:10.1155/2012/585303
PMID:23213591
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3505636/
Abstract

Electroconvulsive therapy (ECT) is commonly used in the management of medication nonresponsive depressive disorder, with proven efficacy in psychiatric practice since many decades. A rare complication of intracranial bleed following this therapeutic procedure has been reported in sporadic case reports in the English literature. We report a case of such a complication in a 42-year-old male, a known case of nonorganic medication nonresponsive depressive disorder for the last two years who required ECT application. Presenting symptoms included altered mental state, urinary incontinence, and repeated episodes of vomiting; following ECT procedure with magnetic resonance imaging (MRI) of the brain suggestive of bilateral acute subdural hematoma. Despite the view that it may be used in neurological conditions without raised intracranial tension, it will be worthwhile to be vigilant during post-ECT recovery for any emergent complications.

摘要

电休克疗法(ECT)常用于治疗药物难治性抑郁症,数十年来在精神病学实践中已证实其有效性。英文文献中的散发病例报告曾报道过该治疗程序后发生颅内出血这一罕见并发症。我们报告一例42岁男性出现这种并发症的病例,该男性在过去两年一直是已知的非器质性药物难治性抑郁症患者,需要接受ECT治疗。其呈现的症状包括精神状态改变、尿失禁和反复呕吐;ECT治疗后脑部磁共振成像(MRI)提示双侧急性硬膜下血肿。尽管有人认为ECT可用于颅内压未升高的神经疾病,但在ECT治疗后的恢复过程中警惕任何紧急并发症是很有必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0810/3505636/b9bde86b1697/CRIM.PSYCHIATRY2012-585303.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0810/3505636/e2e7c880cf63/CRIM.PSYCHIATRY2012-585303.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0810/3505636/b9bde86b1697/CRIM.PSYCHIATRY2012-585303.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0810/3505636/e2e7c880cf63/CRIM.PSYCHIATRY2012-585303.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0810/3505636/b9bde86b1697/CRIM.PSYCHIATRY2012-585303.002.jpg

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Effects of ECT in treatment of depression: study protocol for a prospective neuroradiological study of acute and longitudinal effects on brain structure and function.电休克疗法治疗抑郁症的效果:一项关于对脑结构和功能的急性及纵向影响的前瞻性神经放射学研究的研究方案
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本文引用的文献

1
Chronic subdural hematoma following electro convulsive therapy.电休克治疗后慢性硬膜下血肿
Indian J Psychol Med. 2012 Apr;34(2):181-3. doi: 10.4103/0253-7176.101799.
2
An examination of mortality and other adverse events related to electroconvulsive therapy using a national adverse event report system.使用国家不良事件报告系统检查与电抽搐治疗相关的死亡率和其他不良事件。
J ECT. 2011 Jun;27(2):105-8. doi: 10.1097/YCT.0b013e3181f6d17f.
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Titanium alloys as fixation device material for cranioplasty and its safety in electroconvulsive therapy.
钛合金作为颅骨修补固定装置材料及其在电抽搐治疗中的安全性。
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Morbidity and mortality in the use of electroconvulsive therapy.电休克治疗的发病率和死亡率。
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Subdural haematoma: a potentially serious consequence of spontaneous intracranial hypotension.硬膜下血肿:自发性颅内低压的一个潜在严重后果。
J Neurol Neurosurg Psychiatry. 2003 Jun;74(6):752-5. doi: 10.1136/jnnp.74.6.752.
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Electroconvulsive Therapy and Chronic Subdural Hematoma.电休克治疗与慢性硬膜下血肿
Convuls Ther. 1990;6(1):38-41.
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An analysis of reported deaths following electroconvulsive therapy in Texas, 1993-1998.1993年至1998年得克萨斯州电休克治疗后报告死亡病例的分析。
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