Ramírez Sofía, Gredilla Elena, Martínez Blanca, Gilsanz Fernando
Serviço de Anestesiologia e Reanimação, Hospital Universitário La Paz, Madri, Espanha.
Serviço de Anestesiologia e Reanimação, Hospital Universitário La Paz, Madri, Espanha.
Rev Bras Anestesiol. 2015 Jul-Aug;65(4):306-9. doi: 10.1016/j.bjan.2014.07.002. Epub 2015 Apr 29.
We report the case of a 25-year-old woman, who received epidural analgesia for labour pain and subsequently presented post-dural puncture headache. Conservative treatment was applied and epidural blood patch was performed. In the absence of clinical improvement and due to changes in the postural component of the headache, a brain imaging test was performed showing a bilateral subdural hematoma. The post-dural puncture headache is relatively common, but the lack of response to established medical treatment as well as the change in its characteristics and the presence of neurological deficit, should raise the suspicion of a subdural hematoma, which although is rare, can be lethal if not diagnosed and treated at the right time.
我们报告了一例25岁女性的病例，该女性因分娩疼痛接受了硬膜外镇痛，随后出现了硬膜穿刺后头痛。采取了保守治疗并进行了硬膜外血贴疗法。由于临床症状未改善且头痛的体位性成分发生变化，进行了脑部成像检查，结果显示双侧硬膜下血肿。硬膜穿刺后头痛相对常见，但对既定治疗方法缺乏反应、其特征发生变化以及出现神经功能缺损，应引起对硬膜下血肿的怀疑，硬膜下血肿虽然罕见，但如果未及时诊断和治疗可能会致命。
