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颅内低压综合征:神经重症监护的重要性

Intracranial Hypotension Syndrome: The Importance of Neurointensive Care.

作者信息

Roriz Carolina, Canelas Maria Ana, Pereira Eduarda

机构信息

Intensive Care Unit, Centro Hospitalar de Leiria, Leiria, PRT.

Intensive Care Unit, Centro Hospitalar de Vila Nova de Gaia/Espinho, Gaia, PRT.

出版信息

Cureus. 2023 Jul 30;15(7):e42673. doi: 10.7759/cureus.42673. eCollection 2023 Jul.

Abstract

Surgical procedures involving the spine can result in various complications, including vascular, nerve root and dura mater injury, surgical wound infection, and hematoma formation. Unintentional durotomy is a frequent complication of these procedures (up to 17%). Two clinical cases are reported in which the occurrence of epileptiform activity in the form of generalized tonic-clonic seizures after instrumentation of the dorsal and lumbar spine raised suspicion of cerebrospinal fluid (CSF) fistula. In both cases, the diagnostic suspicion and early approach allowed for the adoption of a timely medical and surgical plan, with the aim of reducing the volume of lost CSF as well as the potential neurological dysfunction resulting from this surgical complication.

摘要

涉及脊柱的外科手术可能会导致各种并发症,包括血管、神经根和硬脑膜损伤、手术伤口感染以及血肿形成。意外硬脊膜切开是这些手术常见的并发症(发生率高达17%)。本文报告了两例临床病例,在胸段和腰段脊柱内固定术后出现全身性强直阵挛发作形式的癫痫样活动,引发了对脑脊液(CSF)瘘的怀疑。在这两例病例中,通过诊断怀疑和早期处理,得以采取及时的药物和手术方案,目的是减少脑脊液丢失量以及这种手术并发症导致的潜在神经功能障碍。

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