病例报告：因单纯硬膜外静脉血管瘤出血导致硬膜外镇痛后瘫痪。
Case report: Paralysis after epidural analgesia due to a hemorrhage of pure epidural venous hemangioma.
作者信息
Li Jiahui, Xie Pengyun, Liu Xiaolei, Li Daheng, Tang Jing
机构信息
Department of Anesthesiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China.
出版信息
Front Neurol. 2023 Jan 10;13:1077272. doi: 10.3389/fneur.2022.1077272. eCollection 2022.
PURPOSE
To report a case of sudden paralysis after epidural analgesia to raise awareness of the condition and the importance of early identification and appropriate treatment of extradural venous angiomas.
CLINICAL FEATURES
A 28-year-old man with myofascial pain syndrome experienced paraplegia after receiving an epidural block for pain relief, which was later discovered to be caused by hemorrhage from extradural venous angiomas. Decompression surgery was performed immediately and successfully. A follow-up examination was performed 5 months after surgery. The patient reported improvement in urinary retention. The muscle strength in both his lower extremities had recovered to 4 out of 5 but still exhibited considerable residual spasticity.
CONCLUSIONS
Before administering epidural analgesia to relieve undetermined pain, it is prudent to carefully weigh potential benefits against potential risks to patient health to minimize the likelihood of complications.
目的
报告一例硬膜外镇痛后突发瘫痪的病例，以提高对该病症的认识，以及早期识别和妥善治疗硬膜外静脉血管瘤的重要性。
临床特征
一名28岁患有肌筋膜疼痛综合征的男性在接受硬膜外阻滞以缓解疼痛后出现截瘫，后来发现是由硬膜外静脉血管瘤出血所致。立即进行了减压手术，手术成功。术后5个月进行了随访检查。患者报告尿潴留有所改善。其双下肢肌力已恢复至4级（满分5级），但仍有相当程度的残余痉挛。
结论
在给予硬膜外镇痛以缓解不明疼痛之前，谨慎权衡对患者健康的潜在益处与潜在风险，以尽量减少并发症的发生可能性是明智的。
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