Department of Obstetrics & Gynaecology, Ipswich Hospital, Ipswich, Queensland, Australia
Department of Anaesthesia, Ipswich Hospital, Ipswich, Queensland, Australia.
BMJ Case Rep. 2021 Jun 3;14(6):e242160. doi: 10.1136/bcr-2021-242160.
Extra-axial haemorrhage following epidural anaesthesia is extremely rare. We present the case of an 18-year-old G1P0 woman with Alport syndrome who had a ventouse delivery for failure to progress that was complicated by a postpartum tonic-clonic seizure. Clinically, and confirmed radiologically, the patient was found to have experienced an extra-axial haemorrhage (extradural and subdural haemorrhage) secondary to a cerebrospinal fluid leak caused by a dural puncture during epidural anaesthesia. Differentiating between postdural puncture headache, subdural haemorrhage and extradural haemorrhage can be extremely challenging, but it is important to consider these rare conditions when evaluating patients presenting with postpartum headache and seizure.
硬脊膜外麻醉后发生的轴外出血极为罕见。我们报告了一例 18 岁 G1P0 女性，患有 Alport 综合征，因进展性失败行产钳分娩，产后出现强直性阵挛性发作。临床和放射学证实，患者发生了轴外出血（硬脑膜外和硬脑膜下出血），这是由于硬脊膜外麻醉时脑脊液漏引起的。区分硬膜穿刺后头痛、硬膜下血肿和硬脊膜外血肿极具挑战性，但在评估产后头痛和癫痫发作的患者时，必须考虑这些罕见情况。
