氨茶碱治疗剖宫产术后不典型头痛1例

Aminophylline for treatment of typical headache after cesarean section:a case report

硬脊膜穿破后头痛( postdural puncture headache,PDPH)是产科椎管内麻醉后常见并发症之一。通常认为是硬脊膜穿破后脑脊液漏导致颅内压降低而产生。典型的PDPH具有明显的体位特征。硬脊膜穿破后也可并发颅内硬膜下血肿等严重并发症,此时头痛的特征就变得不典型。本文报道1例在硬膜外阻滞下行剖宫产术后出现PDPH的病例,头痛的症状之后变得不典型,CT提示双侧额颞部硬膜下血肿,经氨茶碱治疗头痛明显缓解,且未再复发。

Postdural puncture headache ( PDPH ) is one of the most common complications after obstetric neuraxial anesthesia.The mechanism of PDPH is usually thought to be the decrease of intracranial pressure caused by cerebrospinal fluid leakage after dural puncture.Typically,PDPH has postural characteristics.Severe complications such as intracranial subdural hematoma may occur after dural puncture,and the characteristics of headache become atypical.We report a case of cesarean section under epidural block and PDPH after surgery.The symptoms of headache later became atypical.CT indicated bilateral frontotemporal subdural hematoma,which was significantly relieved after aminophylline treatment and did not recur.