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颅内再出血:脊髓麻醉后妊娠合并慢性硬脑膜下血肿患者的病例报告。

Intracranial rebleeding post spinal anesthesia in pregnant patient with undiagnosed chronic subdural hematoma: case report.

机构信息

CET/SBA Integrado de Uberaba, Uberaba, MG, Brazil.

CET/SBA Integrado de Uberaba, Uberaba, MG, Brazil; Universidade Federal do Triângulo Mineiro (UFTM), Disciplina de Anestesiologia, Uberaba, MG, Brazil.

出版信息

Braz J Anesthesiol. 2022 Jul-Aug;72(4):522-524. doi: 10.1016/j.bjane.2021.08.025. Epub 2021 Nov 28.

Abstract

Intracranial hematoma after spinal anesthesia is a rare complication. It generally presents with posture-dependent headache that becomes persistent. We describe the case of patient submitted to spinal anesthesia for cesarean section who presented a non-posture-dependent headache, resistant to clinical treatment, that progressively worsened and with symptoms of intracranial hypertension. The patient had a history of head trauma without symptoms. The CT-scan revealed a chronic bilateral parietal hematoma with a recent bleeding component, treated surgically. We concluded that spinal puncture led to chronic hematoma to rebleed. We have reported the case to draw attention to the importance of investigating atypical headache after spinal anesthesia.

摘要

椎管内麻醉后颅内血肿是一种罕见的并发症。它通常表现为体位依赖性头痛,并持续存在。我们描述了一例患者在接受剖宫产椎管内麻醉后出现非体位依赖性头痛,对临床治疗有抵抗力,且逐渐加重,并伴有颅内压升高的症状。患者有头部外伤史,但无明显症状。CT 扫描显示双侧慢性顶骨血肿,近期有出血成分,手术治疗。我们认为,椎管穿刺导致慢性血肿再出血。我们报告此病例旨在提醒大家注意椎管内麻醉后不典型头痛的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b95d/9373423/892af4efcf43/gr1.jpg

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