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子痫前期并发自发性急性硬膜下血肿:一例报告及文献复习

Spontaneous acute subdural hematoma as a complication of preeclampsia. A case report and literature review.

作者信息

Azab Mohammed A, Iqbal Sajid

机构信息

Department of Neurosurgery, Cairo University Hospital, Cairo, Egypt.

Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore General Hospital, Lahore, Pakistan.

出版信息

Surg Neurol Int. 2023 Mar 3;14:81. doi: 10.25259/SNI_22_2023. eCollection 2023.

Abstract

BACKGROUND

Acute subdural hematoma (ASDH) is a common form of intracranial bleeding that may be fatal. Trauma is a major cause, while a subset of cases may occur spontaneously. The authors of this article present a case of spontaneous ASDH in the context of preeclampsia and review similar cases in the literature to identify the prognosis.

CASE DESCRIPTION

A healthy 27-year-old woman presented in her first pregnancy which was complicated with pregnancy-induced hypertension and was sent to a provincial local maternity hospital at 37 weeks of gestation. On day 4 postpartum, the patient complained of severe headache, vomiting and blurred vision. Fundus examination showed papilledema and magnetic resonance imaging showed right acute frontoparietal subdural hematoma. The hematoma was surgically evacuated with decompressive craniotomy. Postoperatively, the patient's symptoms improved.

CONCLUSION

Spontaneous ASDH is a rare event in the context of preeclampsia; however, it should be considered as one of its possible complications. Research should be directed to emphasize on the possibility of spontaneous ASDH as a cause of neurological deterioration in those cases. A proper diagnosis and early intervention for these cases are crucial for both the mother and the fetus.

摘要

背景

急性硬膜下血肿(ASDH)是一种常见的颅内出血形式,可能会致命。创伤是主要原因,而一小部分病例可能会自发发生。本文作者介绍了一例子痫前期患者发生自发性ASDH的病例,并回顾了文献中的类似病例以确定预后。

病例描述

一名健康的27岁女性,首次怀孕,并发妊娠高血压,于妊娠37周时被送往省级当地妇产医院。产后第4天,患者主诉严重头痛、呕吐和视力模糊。眼底检查显示视乳头水肿,磁共振成像显示右侧急性额顶叶硬膜下血肿。通过减压开颅手术清除血肿。术后,患者症状改善。

结论

在子痫前期的情况下,自发性ASDH是一种罕见事件;然而,应将其视为可能的并发症之一。研究应着重强调自发性ASDH作为这些病例神经功能恶化原因的可能性。对这些病例进行正确诊断和早期干预对母亲和胎儿都至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8b9/10070340/1da2d26af0b1/SNI-14-81-g001.jpg

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