剖宫产术后脊髓麻醉后慢性颅内硬膜下血肿：病例报告。
Chronic intracranial subdural hematoma after spinal anesthesia for a cesarean section: a case report.
机构信息
Department of Obstetrics and Gynecology, Saint Paul's Hospital Millennium Medical College, P.O.Box 143079, Addis Ababa, Ethiopia.
Department of Obstetrics and Gynecology, Saint Paul's Hospital Millennium Medical College, P.O.Box 1271, Addis Ababa, Ethiopia.
出版信息
J Med Case Rep. 2021 Oct 7;15(1):492. doi: 10.1186/s13256-021-03100-0.
BACKGROUND
Subdural hematoma is a rare, potentially devastating, yet curable complication of spinal anesthesia. Differentiation between post-dural puncture headache and subdural hematoma can be difficult, resulting in a delay in diagnosis.
CASE PRESENTATION
We present a 28-year-old Ethiopian female patient who underwent elective cesarean section under spinal anesthesia and returned to the emergency department after 1 month with a worsening headache. Brain computed tomography revealed a chronic subdural hematoma with a significant midline shift. The patient recovered completely after surgical evacuation.
CONCLUSIONS
A high index of suspicion and close attention to the pattern and characteristics of the headache, coupled with a meticulous neurologic examination and neuroimaging, can help to achieve timely diagnosis of this serious entity. Investigation with head computed tomography or magnetic resonance imaging is vital.
背景
硬脊膜外血肿是一种罕见但具有潜在破坏性、可治愈的脊髓麻醉并发症。硬膜穿破后头痛和硬脊膜外血肿的鉴别可能较为困难，导致诊断延迟。
病例介绍
我们报告了一位 28 岁的埃塞俄比亚女性患者，她在脊髓麻醉下接受了择期剖宫产，并在 1 个月后因头痛加剧返回急诊。脑计算机断层扫描显示慢性硬脊膜外血肿伴明显中线移位。患者经手术清除后完全康复。
结论
高度怀疑并密切关注头痛的模式和特征，结合细致的神经系统检查和神经影像学检查，有助于及时诊断这种严重疾病。头部计算机断层扫描或磁共振成像检查至关重要。
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