Quintana Amber N, Guragain Richesh, Dean Sophie, Moore Adam, Lee Linden
Anesthesiology, McGovern Medical School, University of Texas Health Science Center, Houston, USA.
Cureus. 2021 Jan 7;13(1):e12558. doi: 10.7759/cureus.12558.
Neuraxial anesthesia is preferred over general anesthesia for cesarean delivery when appropriate because the latter is associated with a higher incidence of airway complications and an increased need for neonatal resuscitation. Common complications of neuraxial anesthesia include backache and headache, whereas feared but rare complications include paraplegia, intraspinal hemorrhage, cauda equina syndrome, nerve injury, and epidural hematoma. This case report presents a 40-year-old female with undiagnosed and asymptomatic ependymoma who presented with concerning neurological symptoms after receiving spinal anesthesia for elective cesarean delivery. Stat lumbar and thoracic spine magnetic resonance imaging (MRI) were performed on postoperative day 13 and were suggestive of a large hypervascular mass with areas of hemorrhage, concerning for ependymoma. An emergent laminectomy and mass resection were performed, resulting in an improvement in the patient's neurological symptoms.
剖宫产时，在适当情况下，神经轴索麻醉优于全身麻醉，因为后者与气道并发症发生率较高以及新生儿复苏需求增加有关。神经轴索麻醉的常见并发症包括背痛和头痛，而令人担忧但罕见的并发症包括截瘫、脊髓内出血、马尾综合征、神经损伤和硬膜外血肿。本病例报告介绍了一名40岁女性，患有未诊断出且无症状的室管膜瘤，在接受择期剖宫产脊髓麻醉后出现了令人担忧的神经症状。术后第13天进行了腰椎和胸椎磁共振成像（MRI）检查，提示有一个大的高血管性肿块，伴有出血区域，怀疑为室管膜瘤。随后进行了紧急椎板切除术和肿块切除术，患者的神经症状得到改善。
