剖宫产脊髓麻醉后颅内硬膜外血肿：一例报告
Intracranial epidural hematoma after spinal anesthesia for cesarean section: a case report.
作者信息
Nagasaka Hiroshi, Horikoshi Yuta, Nakamura Tina, Hoshijima Hiroshi, Imamachi Noritaka, Doi Katsushi, Mieda Tsutomu
机构信息
Department of Anesthesiology, Saitama Medical University Hospital, 38 Morohongo, Moroyamacho, Irumagun, Saitama, 350-0495, Japan.
Division of Dento-Oral Anesthesiology, Tohoku University Graduate School of Dentistry, 4-1 Seiryomachi, Aoba, Sendai, Miyagi, Japan.
出版信息
JA Clin Rep. 2024 Oct 7;10(1):62. doi: 10.1186/s40981-024-00744-x.
BACKGROUND
Although subdural hematoma is a rare complication after spinal anesthesia, there have been no reports of an intracranial epidural hematoma after cesarean section with spinal anesthesia.
CASE PRESENTATION
A 32-year-old nulliparous woman at the 35 week of a twin pregnancy underwent an emergency cesarean section due to her first contraction. She had no preoperative complications and the spinal anesthesia was uneventful, with 0.5% bupivacaine 12 mg and fentanyl 15 µg from the L3/4 intervertebral space. She complained of headache and nausea 15 min after spinal anesthesia, demonstrating a consciousness disturbance after surgery. Computed tomography 2 h after the cesarean section revealed an intracranial epidural hematoma. She underwent decompressive craniotomy 1 h later.
CONCLUSION
This case highlights the possible development of an intracranial epidural hematoma in low-risk obstetric patients.
背景
虽然硬膜下血肿是脊髓麻醉后一种罕见的并发症，但剖宫产脊髓麻醉后发生颅内硬膜外血肿尚无报道。
病例报告
一名32岁未生育的双胎妊娠35周孕妇因首次宫缩行急诊剖宫产。她术前无并发症，脊髓麻醉过程顺利，于L3/4椎间隙注入0.5%布比卡因12mg和芬太尼15μg。脊髓麻醉15分钟后她出现头痛和恶心，术后出现意识障碍。剖宫产术后2小时的计算机断层扫描显示颅内硬膜外血肿。1小时后她接受了减压开颅手术。
结论
该病例凸显了低风险产科患者发生颅内硬膜外血肿的可能性。
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