Çam Bülent M, Akar Semih
Department of Anesthesiology and Reanimation, Amasya University Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, TUR.
Department of Neurosurgery, Amasya University Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, TUR.
Cureus. 2025 May 13;17(5):e84017. doi: 10.7759/cureus.84017. eCollection 2025 May.
A 35-year-old woman with a history of migraine underwent cesarean section under spinal anesthesia using a 25G Quincke needle. On postoperative day two, she developed postdural puncture headache (PDPH) and bilateral tinnitus. Although the headache resolved with intravenous fluids and theophylline, tinnitus persisted. Audiometry revealed bilateral low-frequency sensorineural hearing loss, and cranial MRI confirmed bilateral subdural hematomas (SDHs). She was treated conservatively and discharged without neurological deficits. This case emphasizes the need to consider SDH in the differential diagnosis of PDPH, especially when atypical symptoms such as tinnitus are present. Early imaging is critical to avoid delayed diagnosis and unnecessary morbidity.
一名有偏头痛病史的35岁女性在脊髓麻醉下使用25G Quincke针进行剖宫产。术后第二天，她出现了硬膜穿刺后头痛（PDPH）和双侧耳鸣。尽管头痛通过静脉输液和茶碱得到缓解，但耳鸣持续存在。听力测试显示双侧低频感音神经性听力损失，头颅MRI证实双侧硬膜下血肿（SDH）。她接受了保守治疗，出院时无神经功能缺损。该病例强调在PDPH的鉴别诊断中需要考虑SDH，尤其是当出现耳鸣等非典型症状时。早期影像学检查对于避免延迟诊断和不必要的发病至关重要。
