Serviço de Anestesiologia, Centro Hospitalar e Universitário do Porto, Porto, Portugal.
Serviço de Anestesiologia, Centro Hospitalar e Universitário do Porto, Porto, Portugal.
Rev Esp Anestesiol Reanim (Engl Ed). 2021 Nov;68(9):531-536. doi: 10.1016/j.redare.2020.08.006. Epub 2021 Feb 18.
Epidural analgesia is considered the preferred analgesic choice during labour. Post dural puncture headache (PDPH) is considered a potential complication of this analgesic technique and is a frequently hypothesis for any headache occurring after delivery. It is essential that anaesthetists and obstetricians are familiar with other possible differential diagnosis for postpartum headache (PPH).
37-year-old female presented after delivery with intense occipital pulsatile headache associated with neck radiation, nausea and vomiting, hemodynamically stable and normal neurologic physical examination. Abnormalities in thyroid hormone levels were found. CT-scan findings suggested pituitary apoplexy.
There are many differential diagnoses for PPH and some are rarely considered, such as pituitary apoplexy. It is essential to differentiate signs and symptoms of each diagnosis, since many of them overlap.
Not all postpartum headaches are PDPH and the first suspected diagnosis may not always be accurate.
硬膜外镇痛被认为是分娩过程中首选的镇痛选择。硬膜后穿刺头痛（PDPH）被认为是这种镇痛技术的潜在并发症，并且是分娩后出现任何头痛的常见假设。麻醉师和产科医生熟悉产后头痛（PPH）的其他可能鉴别诊断是至关重要的。
一位 37 岁女性在分娩后出现剧烈的枕部搏动性头痛，伴有颈部放射痛、恶心和呕吐，血流动力学稳定，神经学体检正常。发现甲状腺激素水平异常。CT 扫描结果提示垂体卒中。
PPH 有许多鉴别诊断，有些很少被考虑，如垂体卒中。区分每个诊断的体征和症状非常重要，因为它们中的许多都有重叠。
并非所有产后头痛都是 PDPH，最初怀疑的诊断并不总是准确的。
