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硬膜下血肿作为分娩硬膜外镇痛的后果

Subdural Hematoma as a Consequence of Labor Epidural Analgesia.

作者信息

De Lipsis Luca, Belmonte Rossella, Cusano Maria, Giannetti Maria Antonietta, Muccio Carmine Franco, Mancinelli Mauro

机构信息

Department of Anesthesia, Sacred Heart of Jesus Hospital, Benevento, Italy.

Department of Neuroradiology, G. Rummo Hospital, Benevento, Italy.

出版信息

Asian J Neurosurg. 2018 Jul-Sep;13(3):931-934. doi: 10.4103/ajns.AJNS_115_18.

Abstract

Subdural hematoma (SDH) following labor epidural analgesia is a rare neurological complication. SDH is a late complication of this procedure; it is caused by a leak of cerebrospinal fluid that may damage the vascular structures of the brain. Persistent headache in the days after labor epidural analgesia is a nonspecific clinical symptom caused by hematoma. Preexisting vascular malformations can be a concomitant cause of headache. Clinical cases have been reported even after epidural anesthesia. The differential diagnosis includes unspecified headache, sinusitis headache, drug-induced headache, cortical vein thrombosis, fistula of the dura mater, and bacterial, viral, and aseptic meningitis.

摘要

分娩硬膜外镇痛后发生的硬膜下血肿(SDH)是一种罕见的神经并发症。SDH是该手术的晚期并发症;它是由脑脊液漏引起的,可能会损害脑部的血管结构。分娩硬膜外镇痛后数天持续头痛是由血肿引起的非特异性临床症状。先前存在的血管畸形可能是头痛的伴随原因。即使在硬膜外麻醉后也有临床病例报道。鉴别诊断包括未明确的头痛、鼻窦炎头痛、药物性头痛、皮质静脉血栓形成、硬脑膜瘘以及细菌性、病毒性和无菌性脑膜炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef2a/6159069/3f728a214734/AJNS-13-931-g001.jpg

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