Spinal Anestezi İle Sezeryan Doğum Sonrası Gelişen İntraventriküler Kanama, Olgu Sunumu
Özet
Spinal anestezi, güvenli bir yöntem olmakla birlikte, postdural baş ağrısı gibi yaygın komplikasyonlara neden olabilir. Daha nadir görülen ciddi komplikasyonlardan biri de intrakraniyal kanamalardır. Bu olgu sunumunda, 30 yaşında bir kadın hastada, spinal anestezi sonrası gelişen izole sağ lateral ventrikül içi kanama vakası ele alınmıştır. Hastada operasyon sonrası başlayan baş ağrısı, nörolojik muayene ve beyin görüntülemeleriyle değerlendirildi. Beyin bilgisayarlı tomografisi ve manyetik rezonans görüntüleme ile sağ lateral ventrikülde kanama saptandı. Hastaya yakın nörolojik takip, yatak istirahati ve analjezik tedavi uygulandı. Takiplerinde nörolojik durumunda kötüleşme olmadı ve kanama geriledi. Bu vaka, spinal anestezi sonrası intraventriküler kanama gibi nadir bir komplikasyonu içermesi ve genç yaşta, ek risk faktörleri bulunmayan bir hastada gelişmesi açısından dikkat çekicidir. Spinal anestezi sonrası şiddetli ve dirençli baş ağrısı durumunda, intrakraniyal hemoraji riski göz önünde bulundurulmalı ve erken tanı ile tedavi sağlanmalıdır.
Although spinal anesthesia is generally a safe procedure, it can lead to common complications such as post-dural headaches. A rarer but more serious complication is intracranial hemorrhage. This case report presents a 30-year-old female patient who developed an isolated right lateral intraventricular hemorrhage following spinal anesthesia. The patient experienced a headache after the procedure, which was assessed through neurological examination and brain imaging. A hemorrhage in the right lateral ventricle was identified via brain computer tomography and magnetic resonance imaging. The patient received close neurological monitoring, bed rest, and analgesic treatment. During follow-up, no neurological deterioration occurred, and the hemorrhage regressed. This case is noteworthy because it involves the rare complication of intraventricular hemorrhage after spinal anesthesia in a young patient without additional risk factors. In cases of severe and persistent headaches following spinal anesthesia, the risk of intracranial hemorrhage should be consid.
Referanslar
Crofts T, Monagle J, Buist M, Burnes J. Bilateral frontal haemorrhages associated with continuous spinal analgesia. Anaesthesia and intensive care. 2001;29(1):51-3.
Scott D, HIBBARD BM. Serious non-fatal complications associated with extradural block in obstetric practice. British Journal of Anaesthesia. 1990;64(5):537-41.
Mordecai MM, Brull SJ. Spinal anesthesia. Current Opinion in Anesthesiology. 2005;18(5):527-33.
Macon ME, Armstrong L, Brown E. Subdural hematoma following spinal anesthesia. Obstetric Anesthesia Digest. 1990;10(2):108.
Acharya R. Chronic subdural haematoma complicating spinal anaesthesia. Neurological Sciences. 2005;25:348-50.
Zeidan A, Farhat O, Maaliki H, Baraka A. Does postdural puncture headache left untreated lead to subdural hematoma? Case report and review of the literature. International journal of obstetric anesthesia. 2006;15(1):50-8.
Shaikh JM, Memon A, Memon MA, Khan M. Post dural puncture headache after spinal anaesthesia for caesarean section: a comparison of 25 g Quincke, 27 g Quincke and 27 g Whitacre spinal needles. J Ayub Med Coll Abbottabad. 2008;20(3):10-3.
Referanslar
Crofts T, Monagle J, Buist M, Burnes J. Bilateral frontal haemorrhages associated with continuous spinal analgesia. Anaesthesia and intensive care. 2001;29(1):51-3.
Scott D, HIBBARD BM. Serious non-fatal complications associated with extradural block in obstetric practice. British Journal of Anaesthesia. 1990;64(5):537-41.
Mordecai MM, Brull SJ. Spinal anesthesia. Current Opinion in Anesthesiology. 2005;18(5):527-33.
Macon ME, Armstrong L, Brown E. Subdural hematoma following spinal anesthesia. Obstetric Anesthesia Digest. 1990;10(2):108.
Acharya R. Chronic subdural haematoma complicating spinal anaesthesia. Neurological Sciences. 2005;25:348-50.
Zeidan A, Farhat O, Maaliki H, Baraka A. Does postdural puncture headache left untreated lead to subdural hematoma? Case report and review of the literature. International journal of obstetric anesthesia. 2006;15(1):50-8.
Shaikh JM, Memon A, Memon MA, Khan M. Post dural puncture headache after spinal anaesthesia for caesarean section: a comparison of 25 g Quincke, 27 g Quincke and 27 g Whitacre spinal needles. J Ayub Med Coll Abbottabad. 2008;20(3):10-3.
