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硬膜外血贴治疗产科硬膜穿刺后头痛患者后发生的症状性鞘内血肿:一例报告及文献综述

Symptomatic Intrathecal Hematoma following an Epidural Blood Patch for an Obstetric Patient with Postdural Puncture Headache: A Case Report and Synthesis of the Literature.

作者信息

McInerney Hailey J, Lee Manuel, Saunders Tracie, Schabel Joy, Adsumelli Rishimani S N

机构信息

Renaissance School of Medicine at Stony Brook University, Stony Brook, NY 11794, USA.

Department of Anesthesia, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY 11794, USA.

出版信息

Case Rep Anesthesiol. 2020 Mar 18;2020:8925731. doi: 10.1155/2020/8925731. eCollection 2020.

Abstract

Epidural blood patch (EBP), generally considered a low-risk procedure, can potentially lead to significant neurological complications. We report the case of a parturient who underwent an uneventful EBP for postdural puncture headache (PDPH) and subsequently presented with progressively worsening radicular symptoms. Magnetic resonance imaging (MRI) revealed an intrathecal hematoma, and conservative management with steroids led to complete recovery. Our case highlights the possibility of this rare complication following an uneventful procedure and the importance of prompt diagnosis and treatment to prevent serious adverse outcomes. Literature review, EBP alternatives, and strategies to minimize complications following blood patch will be discussed in this report.

摘要

硬膜外血贴疗法(EBP)通常被认为是一种低风险的操作,但仍有可能导致严重的神经并发症。我们报告了一例产妇的病例,该产妇因硬膜穿刺后头痛(PDPH)接受了顺利的EBP治疗,随后出现神经根症状逐渐加重。磁共振成像(MRI)显示鞘内血肿,使用类固醇进行保守治疗后完全康复。我们的病例强调了在看似顺利的操作后出现这种罕见并发症的可能性,以及及时诊断和治疗以预防严重不良后果的重要性。本报告将讨论文献综述、EBP替代方法以及减少血贴后并发症的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bfe/7104125/e3a8ee8c5e09/CRIA2020-8925731.001.jpg

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