手术后脑脊液漏的血贴:病例报告

Martinez Herrera Alvaro, Galvan Talamantes Yazmín, Alvarez Resendiz Gerardo, Chalita Perez-Tagle Christinan, Kleriga Grossgerge Enrique, Zambito Brondo Gerardo
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引用次数: 0

摘要

颅内低血压综合征可能继发于脑脊液漏(CSFL)。其病因可能是先天性、外伤性或自发性的。最常见的病因与麻醉过程中偶然或故意的穿刺有关。它是腰椎手术中一种罕见的并发症。该综合征的临床表现以正位性头痛为最常见症状,伴有多种表现,常常导致日常生活活动障碍和延迟康复。诊断需要通过详细的病史、症状和体征以及其他影像学检查。初期治疗以保守疗法为主,但建议相当多的患者下一步使用血液补片,对于这些措施都无法解决的病例,则保留手术治疗。本文介绍了一例 56 岁女性患者的临床病例,该患者在手术后被诊断为 CSF 瘘,通过使用血补片治疗后症状完全缓解;同样,本文也提出了 CSFL 诊断的治疗算法。
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Blood Patch for Post-Surgical Cerebrospinal Fluid Leak: A Case Report
Intracranial hypotension syndrome may occur secondary to Cerebrospinal Fluid Leak (CSFL). Its etiology can be iatrogenic, traumatic or spontaneous. The most common cause is related to incidental or intentional punctures during anesthetic approaches. It is a rare complication during lumbar spine surgery. The clinical manifestations of this syndrome are characterized by orthostatic headache as the most frequent symptom, accompanied by a wide variety of manifestations, which frequently result in a disability for daily life activities and a delayed recovery. Diagnosis is made through a detailed medical history, the presence of symptoms and signs, and additional imaging studies. Initial treatment is conservative; however, using a hematic patch is recommended for a significant number of patients as the next step, reserving surgical treatment for cases that are not resolved with these measures. This paper presents the clinical case of a 56-year-old female patient diagnosed with CSF fistula following a surgical procedure, which is treated by applying a blood patch with complete remission of symptoms; similarly, a therapeutic algorithm is proposed for the diagnosis of CSFL.
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