Abstract:
Subdural hematoma is an uncommon complication of epidural analgesia or diagnostic lumbar puncture. Headache is a common complaint for patients with either a subdural hematoma or a post-dural puncture headache. Because post-dural puncture headaches are commonly seen in the Emergency Department, the potential to miss more serious pathology arises. We present the case of a young female who suffered bilateral subdural hematomas following epidural analgesia during childbirth. She presented twice to the Emergency Department and was treated for a post-dural puncture headache before computed tomography imaging revealed the diagnosis on the third Emergency Department encounter. This case highlights the importance of exploring all potential diagnoses when a patient presents with a headache after either epidural analgesia or a diagnostic lumbar puncture, especially if the patient returns after unsuccessful treatment for a presumptive post-dural puncture headache.
摘要:
硬膜下血肿是硬膜外镇痛或诊断腰椎穿刺的罕见并发症。头痛是硬膜下血肿或硬膜穿刺后头痛患者的常见病。因为硬脑膜穿刺后头痛常见于急诊科,可能会错过更严重的病理。我们介绍了一名年轻女性在分娩时硬膜外镇痛后遭受双侧硬膜下血肿的情况。她两次向急诊科就诊,并接受了硬脑膜穿刺后头痛的治疗,然后计算机断层扫描成像显示了第三次急诊科的诊断。该病例强调了当患者在硬膜外镇痛或诊断腰椎穿刺后出现头痛时,探索所有潜在诊断的重要性。特别是如果患者在硬脑膜穿刺后头痛治疗不成功后返回。