Dauleac C, Vinckier F, Bourdillon P
Department of neurosurgery, Hospices civils de Lyon, Hospital for neurology and neurosurgery Pierre Wertheimer, 69003, Lyon, France; Université de Lyon, Université Claude-Bernard, 69003, Lyon, France.
Department of psychiatry, Sainte-Anne Hospital, 75014, Paris, France; Université Sorbonne Paris cité, Université René-Descartes, 75005, Paris, France; Inserm U1127, CNRS 7225, Brain and spine institute, 75006, Paris, France.
Neurochirurgie. 2019 Feb;65(1):40-42. doi: 10.1016/j.neuchi.2018.11.001. Epub 2018 Dec 13.
Electroconvulsive therapy (ECT) is a common therapeutic procedure in psychiatry associated with a low rate of complications. We report a rare case of subdural hematoma (SDH) associated with ECT.
a 64 year old woman, with a medical history of persistent depression which required ECT six years previously, underwent ECT following a new acute episode. After four ECT sessions, a left hemiparesis occurred. Brain CT scan revealed a right SDH. The patient underwent surgery and fully recovered three months after the drainage of the hematoma. We conducted a review of all cases in which SDH was associated to ECT.
Early stage brain imaging is indispensable prior to starting ECT. Moreover, a previous medical history of SDH may not be a contraindication to ECT. In these situations, a clinical and radiological follow-up by both the psychiatrist and the neurosurgeon during all the ECT sessions is highly recommended.
电休克疗法（ECT）是精神病学中一种常见的治疗方法，并发症发生率较低。我们报告一例罕见的与ECT相关的硬膜下血肿（SDH）病例。
一名64岁女性，有持续性抑郁症病史，六年前曾接受ECT治疗，在一次新的急性发作后接受了ECT治疗。经过四次ECT治疗后，出现左侧偏瘫。脑部CT扫描显示右侧硬膜下血肿。患者接受了手术，血肿引流三个月后完全康复。我们对所有与ECT相关的硬膜下血肿病例进行了回顾。
在开始ECT治疗前，早期脑部影像学检查必不可少。此外，既往有硬膜下血肿病史可能不是ECT的禁忌症。在这些情况下，强烈建议精神科医生和神经外科医生在所有ECT治疗期间进行临床和影像学随访。
