緊急帝王切開術の脊髄くも膜下麻酔後に硬膜下血腫を来した1症例

A Case of Subdural Hematoma after Spinal Subarachnoid Anesthesia for Emergency Cesarean Section

要旨

　緊急帝王切開術のために脊髄くも膜下麻酔を施行し，術後1日目から硬膜穿刺後頭痛を認めたが，遷延するため術後5日目に画像検査を行ったところ頭蓋内硬膜下血腫を認めた。頭痛が遷延したり頭痛の性状が変化するときは硬膜下血腫を念頭に置き，画像検査を行う必要がある。

　We performed spinal subarachnoid anesthesia for a patient undergoing emergency cesarean section. She developed postdural puncture headache（PDPH）on the first postoperative day. She had no neurological symptoms, but imaging studies performed on postoperative day 5 because of the prolonged headache, revealed an intracranial subdural hematoma.

　When PDPH is prolonged or the nature of the headache changes, intracranial subdural hematoma should be considered and imaging studies should be performed aggressively.