Nagasaka Hiroshi, Horikoshi Yuta, Nakamura Tina, Hoshijima Hiroshi, Imamachi Noritaka, Doi Katsushi, Mieda Tsutomu
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.
JA Clin Rep. 2024 Oct 7;10(1):62. doi: 10.1186/s40981-024-00744-x.
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.
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.
This case highlights the possible development of an intracranial epidural hematoma in low-risk obstetric patients.
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。
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。
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。
