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剖宫产脊髓麻醉后颅内硬膜下血肿

Intracranial subdural hematoma after spinal anesthesia for cesarean section.

作者信息

Schweiger Vittorio, Zanconato Giovanni, Lonati Gisella, Baggio Silvia, Gottin Leonardo, Polati Enrico

机构信息

Department of Anesthesiological Sciences and Specialistic Surgeries, University of Verona, 37134 Verona, Italy.

Department of Life Science and Reproduction, University of Verona, 37134 Verona, Italy ; U.O. di Ginecologia e Ostetricia, Policlinico Borgo Roma, 37134 Verona, Italy.

出版信息

Case Rep Obstet Gynecol. 2013;2013:253408. doi: 10.1155/2013/253408. Epub 2013 Dec 24.

Abstract

Intracranial subdural hematoma following spinal anesthesia is an infrequent occurrence in the obstetric population. Nevertheless, it is a potentially life-threatening complication. In the majority of the cases, the first clinical symptom associated with intracranial subdural bleeding is severe headache, but the clinical course may have different presentations. In this report, we describe the case of a 38-year-old woman with an acute intracranial subdural hematoma shortly after spinal anesthesia for cesarean section. Early recognition of symptoms of neurologic impairment led to an emergency craniotomy for hematoma evacuation with good recovery of neurologic functions. The possibility of subdural hematoma should be considered in any patient complaining of severe persistent headache following regional anesthesia, unrelieved by conservative measures. Only early diagnosis and an appropriate treatment may avoid death or irreversible neurologic damage.

摘要

脊髓麻醉后发生颅内硬膜下血肿在产科人群中并不常见。然而,这是一种潜在的危及生命的并发症。在大多数病例中,与颅内硬膜下出血相关的首个临床症状是严重头痛,但临床病程可能有不同表现。在本报告中,我们描述了一例38岁女性在剖宫产脊髓麻醉后不久发生急性颅内硬膜下血肿的病例。对神经功能损害症状的早期识别导致紧急开颅清除血肿,神经功能恢复良好。对于任何在区域麻醉后出现严重持续性头痛且保守措施无法缓解的患者,都应考虑硬膜下血肿的可能性。只有早期诊断和适当治疗才能避免死亡或不可逆的神经损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b23/3884612/468a0605293b/CRIM.OBGYN2013-253408.001.jpg

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