经过成功的血贴后,产后刺痛头痛的复发
João Barbosa1, Maria Valentim1, Mariana Almeida1
1Anesthesiology Department, Hospital de Braga, Braga, PRT.
Cureus
|December 11, 2023
概括
产科患者的持续性刺伤后头痛 (PDPH) 可能在外周血补丁 (EBP) 治疗后复发. 这一案例凸显了管理PDPH及其并发症的多学科护理的必要性.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 神经学 神经学
背景情况:
- 产后刺痛头痛 (PDPH) 是在产科医生群体中脊髓麻醉后的一个常见并发症.
- 腹腔外血贴片 (EBP) 是耐火性PDPH的标准治疗方法.
研究的目的:
- 在产科患者中报告EBP后出现复发性PDPH与腹膜下湿瘤的病例.
- 强调在管理PDPH及其并发症方面采用多学科方法的重要性.
主要方法:
- 一个35岁的绝育妇女的案例报告.
- 最初的治疗方法是 epidural blood patch (EBP) 的使用.
- 大脑CT扫描用于在症状复发时诊断腹腔下湿瘤.
主要成果:
- 在EBP之后,症状立即消失.
- 在出院后三天,PDPH症状的复发.
- 通过CT扫描证实了皮肤下皮质湿瘤的诊断.
结论:
- 即使在成功的EBP之后,PDPH也可能会出现延迟或复发的并发症.
- 麻醉学,产科和神经病学之间的多学科合作对于综合管理至关重要.
- 腹膜下湿瘤是一种罕见但严重的PDPH并发症,需要及时进行神经学评估.
关键词:
大脑脊髓液低血压 脑脊液低血压epidural epidural 周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周腹腔穿刺后的头痛 头痛皮下血腫 (subdural hematomas) 是一種皮下血腫.皮下皮质湿瘤是什么?意外的持续性穿刺是无意的相关概念视频
Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Brain Abscess l: Introduction
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...


