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一个病例在内镜洞手术期间呈现逆轨道疼痛,因为有组织的慢性腹腔内血瘤

Shoko Merrit Yamada¹, Ryogo Ichinose²

¹Department of Neurosurgery, Shizuoka Welfare Hospital, Shizuoka, Japan.

Surgical neurology international

|March 5, 2026

概括

慢性下皮质血瘤手术期间的逆轨道疼痛可能表明危险的快速大脑扩张. 这种罕见的症状表明需要立即停止手术,以防止诸如内出血等并发症.

科学领域:

神经外科神经外科
神经学神经学

背景情况:

在慢性腹腔内血瘤 (CSDH) 的孔灌过程中,逆轨道疼痛异常罕见.
一名65岁的男性在CSDH手术后出现了残留的血瘤和运动弱点.

研究的目的:

报告一个罕见的病例,在内镜膜切除期间出现逆轨道疼痛,以治疗慢性腹腔内血瘤.
突出快速大脑减压的潜在风险,并建议采用两阶段的手术方法.

主要方法:

在局部麻醉下进行内镜去除有组织的慢性腹膜下血瘤和内膜.
监测患者的症状和术后成像.

主要成果:

患者在内膜切除过程中出现了严重的逆轨道疼痛,这表明大脑迅速扩张.
手术后的成像显示了下关节和脑内出血以及内脑动脉扩张.
患者恢复了出行功能,但仍然失方向.

结论:

慢性腹腔内血瘤的侵袭性膜切除术可能会由于快速减压而导致内出血的风险.
逆轨道疼痛可能是脑血流过度增加的关键预警信号,需要立即停止手术.
一个分阶段的手术方法可以减轻与快速减压相关的风险.

关键词:

大脑的血液流动.慢性腹膜下血腫慢性腹膜下血腫内膜的内部膜是什么?逆轨道疼痛是一种逆轨道疼痛.三胞胎的自主反射反应

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