Melo M C, Revuelta M E, Santeularia T, Genové M, Català E
Servicio de Anestesiología y Reanimación, Clínica del Dolor, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
Servicio de Anestesiología y Reanimación, Clínica del Dolor, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
Rev Esp Anestesiol Reanim. 2015 Nov;62(9):533-5. doi: 10.1016/j.redar.2015.01.008. Epub 2015 Feb 16.
Spontaneous intracranial hypotension headache is an uncommon disease that resolves spontaneously in most of the cases and in a short period of time. The initial treatment should be symptomatic. In some patients the symptomatology is extremely disabling, and in these cases both the diagnosis and treatment may be performed by an epidural blood patch. A 49-year-old Caucasian woman, with no previous record of epidural or intrathecal puncture, consulted in the Emergency Department complaining of a 9-day history of frontal headache and diplopia, along with nausea and vomiting. The patient was diagnosed with spontaneous intracranial hypotension headache. Considering the symptomatology and the uncontrolled pain, the Pain Unit of our hospital performed an epidural blood patch. In the first 24h the patient reported a remarkable relief of both headache and diplopia but developed a left lumbar radiculopathy that was treated successfully with supportive measures. Transient lumbar radiculopathy is a common and acceptable event secondary to the use of epidural blood patch as a treatment for spontaneous intracranial hypotension headache.
自发性颅内低压性头痛是一种罕见疾病，大多数情况下可在短时间内自行缓解。初始治疗应为对症治疗。在一些患者中，症状极为严重，在这些病例中，诊断和治疗均可通过硬膜外血贴进行。一名49岁的白种女性，既往无硬膜外或鞘内穿刺史，因前额头痛、复视9天，伴有恶心和呕吐，到急诊科就诊。该患者被诊断为自发性颅内低压性头痛。考虑到症状和疼痛未得到控制，我院疼痛科进行了硬膜外血贴治疗。在最初的24小时内，患者报告头痛和复视均明显缓解，但出现了左侧腰神经根病，通过支持性措施成功治愈。短暂性腰神经根病是硬膜外血贴治疗自发性颅内低压性头痛后的常见且可接受的并发症。
