The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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A Case of Subdural Hematoma after Epidural Blood Patch in a Spontaneous Intracranial Hypotensive Patient - A case report -

자발성 두개강내 저혈압성 두통 환자에서 치료 도중 발생한 경막하혈종 - 증례보고 -

  • Kim, Yeui Seok (Pain Clinic, Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University) ;
  • Han, Kyung Ream (Pain Clinic, Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University) ;
  • Kim, Chan (Pain Clinic, Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University)
  • 김의석 (아주대학교 의과대학 마취통증의학교실) ;
  • 한경림 (아주대학교 의과대학 마취통증의학교실) ;
  • 김찬 (아주대학교 의과대학 마취통증의학교실)
  • Received : 2007.05.07
  • Accepted : 2007.10.30
  • Published : 2007.12.10
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Abstract

Spontaneous intracranial hypotension (SIH) is believed to be a benign disease. However, numerous studies have reported serious complications related to SIH, including subdural hematoma. In this case report, a 54-year-old male patient visited the emergency room with orthostatic headache. A brain magnetic resonance imaging (MRI) study showed diffuse mild thickening and enhancement of pachymeninges, with a suspicious minimal amount of subdural fluid collected in the left posterior parietal area. His orthostatic headache showed no improvement with conservative treatment; but his pain was almost completely relieved after two trials of cervical epidural blood patch. On the 74th day after the onset of his pain, the patient showed a drowsy mental status and slurred speech when he visited the pain clinic. Brain computerized tomography indicated a left subdural hemorrhage, and he underwent emergency operation to drain the SDH. In conclusion, pain clinicians should pay attention to abrupt changes in mental status as well as continuous headache, for the early diagnosis of SDH in SIH patients.

Keywords

References

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