产科病人脊髓麻醉后颅内低血压伴硬膜下血肿:一种罕见但致命的并发症。

IF 1.3 Q3 ANESTHESIOLOGY Saudi Journal of Anaesthesia Pub Date : 2024-01-01 Epub Date: 2024-01-02 DOI:10.4103/sja.sja_356_23
Sujit J Kshirsagar, Anandkumar H Pande, Sanyogita V Naik, Neha M Kamble
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引用次数: 0

摘要

剖腹产脊髓麻醉后硬膜下血肿(SDH)形式的颅内出血伴颅内低血压是一种罕见病,发病率约为产科人口的五百万分之一。由于其表现与硬膜穿刺后头痛(PDPH)相似,有时会被误诊。持续头痛超过 5 天、呕吐、视力模糊和抽搐可作为诊断颅内出血的依据。磁共振成像(MRI)有助于诊断此类患者出血的位置、大小和其他异常情况。治疗方法包括保守治疗和开颅手术治疗。在此,我们介绍了一例 19 岁女性的病例,她在脊髓麻醉下接受剖宫产手术,术后第 6 天(POD)出现 SDH 和颅内低血压。她接受了保守治疗,包括大量静脉输液、卧床休息、低头位、镇痛药和抗癫痫药。14 天后再次进行了计算机断层扫描(CT),结果显示 SDH 已缓解,患者痊愈出院。
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Intracranial hypotension with subdural hematoma after spinal anesthesia in obstetric patient: A rare but fatal complication.

Intracranial bleed in the form of subdural hematoma (SDH) with intracranial hypotension after spinal anesthesia for cesarean section is a rare condition with an incidence of around 1 in 5,00,000 obstetric populations. As its presentation is similar to post-dural puncture headache (PDPH), it can be misdiagnosed sometimes. Persistent headache for more than 5 days, vomiting, blurring of vision, and convulsion can guide the diagnosis of intracranial bleed. Magnetic resonance imaging (MRI) helps to diagnose the location, size, and other abnormalities of bleed in such patients. The management ranges from conservative to surgical management in the form of craniotomy. Here, we present a case of a 19-year-old woman, who operated on for cesarean section under spinal anesthesia presented with SDH and intracranial hypotension on postoperative day (POD) 6. She was managed conservatively with plenty of intravenous (IV) fluids, bed rest, low head position, analgesics, and antiepileptics. A repeat computed tomography (CT) scan was performed after 14 days, which showed resolved SDH, and the patient was discharged.

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来源期刊
CiteScore
1.90
自引率
8.30%
发文量
141
审稿时长
36 weeks
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