Sorour Mohammad, Krisht Khaled M, Couldwell William T
Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, UT 84132, USA.
Case Rep Neurol Med. 2014;2014:406289. doi: 10.1155/2014/406289. Epub 2014 Dec 4.
The authors present two cases of intraventricular hemorrhage (IVH) believed to be a result of epidural blood patching. The first was a 71-year-old woman who had new onset of nontraumatic IVH on computed tomography (CT) scan after undergoing an epidural blood patch (EBP). This amount of intraventricular blood was deemed an incidental finding since it was of very small volume to account for her overall symptoms. The second patient, a 29-year-old woman, was found to have nontraumatic IVH three days after undergoing an EBP. This was seen on CT scan of the head for workup of pressure-like headaches, nausea, vomiting, and absence seizures. Conservative management was followed in both instances. Serial CT scan of the head in our first patient displayed complete resolution of her IVH. The second patient did not have follow-up CT scans because her overall clinical picture had improved significantly. This highlights a potential sequel of EBP that may be observed on CT scan of the head. In the event that IVH is detected, signs and symptoms of hydrocephalus should be closely monitored with the consideration for a future workup if warranted by the clinical picture.
作者报告了两例被认为是硬膜外血补丁所致的脑室内出血（IVH）病例。第一例是一名71岁女性，在接受硬膜外血补丁（EBP）后，计算机断层扫描（CT）显示出现非创伤性IVH。脑室内的血量被视为偶然发现，因为其体积非常小，无法解释她的整体症状。第二例患者是一名29岁女性，在接受EBP三天后被发现有非创伤性IVH。这是在对类似压力性头痛、恶心、呕吐和失神发作进行检查的头部CT扫描中发现的。两例均采取保守治疗。我们的首例患者头部的系列CT扫描显示其IVH完全消退。第二例患者没有进行后续CT扫描，因为她的整体临床情况有显著改善。这突出了EBP可能在头部CT扫描中观察到的一个潜在后遗症。如果检测到IVH，应密切监测脑积水的体征和症状，并根据临床情况在必要时考虑未来的检查。
