Motsch J, Hutschenreuter K
Reg Anaesth. 1984 Apr;7(2):74-6.
Prolonged liquor fistula following puncture of the subdural space for diagnostic or anaesthetic purposes has been reported repeatedly. These among other factors are held responsible for headache as well as neurological complications in connection with lumbar puncture. In contrast the appearance of an external liquor fistula in the lumbar region is an extremely rare event. Two patients developed a cutaneous liquor fistula after lumbar laminectomy following an inadvertant dural penetration when an epidural steroid injection was performed. The same occurred in a healthy young patient who had undergone several trials to puncture the epidural space for an epidural anaesthesia in a case of emergency cesarean section Our own observation concerns a 62 years old woman who developed a cutaneous cerebrospinal fluid fistula 12 h after the removal of an epidural catheter, which had caused a secondary perforation of the dura.
为诊断或麻醉目的穿刺硬膜下腔后出现长时间脑脊液瘘的情况已被多次报道。这些因素以及其他因素被认为是导致与腰椎穿刺相关的头痛和神经并发症的原因。相比之下,腰椎区域出现外部脑脊液瘘是极为罕见的事件。两名患者在腰椎椎板切除术后因硬膜外类固醇注射时意外穿透硬膜而出现皮肤脑脊液瘘。一名健康的年轻患者在急诊剖宫产时为进行硬膜外麻醉多次尝试穿刺硬膜外腔后也出现了同样的情况。我们自己观察到一名62岁女性在拔除硬膜外导管后12小时出现皮肤脑脊液瘘,该导管导致了硬膜的继发性穿孔。