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一例脊麻后慢性硬膜下血肿延迟诊断的病例。

A case of late diagnosis of chronic subdural hematoma following spinal anesthesia.

作者信息

Aygun Ali, Vuran Hava Semra, Aksut Nurhak, Karaca Yunus, Tatli Ozgur

机构信息

Ordu University Training and Research Hospital, Department of Emergency Medicine, Ordu, Turkey.

Fatih State Hospital, Department of Emergency Medicine, Trabzon, Turkey.

出版信息

Turk J Emerg Med. 2017 Mar 19;17(2):68-69. doi: 10.1016/j.tjem.2016.11.003. eCollection 2017 Jun.

Abstract

Intracranial subdural hematoma developing following spinal anesthesia is a rare but serious complication. We describe a case of subdural hematoma developing following spinal anesthesia and diagnosed late. A female patient receiving spinal anesthesia for cesarean delivery 45 days prior to arrival at the emergency department presented to our hospital with non-severe headache persisting for 45 days after discharge. Computerized tomography (CT) of the brain performed due to long-term persisting headache resistant to medical treatment and a history of spinal intervention revealed a hypodense chronic subdural hematoma in the left frontoparietal area and a shift from left to right in midline structures. The patient was operated and discharged without sequelae on the 7th day postoperatively. Care must be taken over subdural hematoma in the presence of headache after spinal anesthesia persisting despite fluid intake and medical treatment and exceeding 48 h in duration, and diagnosis must not be delayed.

摘要

脊髓麻醉后发生颅内硬膜下血肿是一种罕见但严重的并发症。我们描述了一例脊髓麻醉后发生硬膜下血肿且诊断较晚的病例。一名女性患者在到达急诊科前45天接受剖宫产脊髓麻醉,出院后持续45天出现非重度头痛,遂来我院就诊。因长期持续性头痛药物治疗无效且有脊髓干预史,行脑部计算机断层扫描(CT),结果显示左额顶叶区域有低密度慢性硬膜下血肿,中线结构从左向右移位。患者术后第7天接受手术,出院时无后遗症。对于脊髓麻醉后出现头痛,尽管补液和药物治疗仍持续存在且持续时间超过48小时的情况,必须警惕硬膜下血肿,且诊断不应延迟。

相似文献

1
A case of late diagnosis of chronic subdural hematoma following spinal anesthesia.一例脊麻后慢性硬膜下血肿延迟诊断的病例。
Turk J Emerg Med. 2017 Mar 19;17(2):68-69. doi: 10.1016/j.tjem.2016.11.003. eCollection 2017 Jun.
10
Subdural hematoma as a late complication of spinal anesthesia.
J Neurosurg Anesthesiol. 2003 Jan;15(1):47-9. doi: 10.1097/00008506-200301000-00008.

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