摘要
<b><span style="font-family:Verdana;">Introduction: </span></b>Cerebral venous thrombosis (CVT) is a rare complication of spinal anesthesia. The diagnosis is difficult when it occurs by isolated headache, following post spinal puncture headache (PSPH). We report a case of cerebral venous thrombosis complicating PSPH, following <span>a spinal</span> anesthesia. <b><span>Observation:</span></b><span> A 23-year-old man was admitted to the emergency room for</span> PSPH appeared 6 hours after a spinal <span>aesthesia</span> for removal of osteosynthesis equipment from the<span style="font-family:Verdana;"></span><span style="font-family:;" "=""> right tibial plateau. The headache was <span>fronto</span>-occipital, relieved by lying down. Six days later, <span>headache</span> became permanent, not relieved by morphine, associated with vomiting. The neurological examination was normal. Brain magnetic resonance Magnetic venography showed superior sagittal sinus and right transverse sinus thrombosis. After administration of low molecular weight heparin at curative dose, and warfarin under INR control, the evolution was marked by a rapid regression of headaches on the same day. After a 1-year <span>setback,</span> the patient was asymptomatic. <b>Conclusion:</b> CVT is a rare complication of spinal anesthesia and potentially severe if diagnosed lately. Urgent brain imaging must be performed for any atypical headache or the onset of neurological disorders so as not to misunderstand cerebral vein thrombosis. Controlling the spine anesthesia would reduce the inadvertent perforation of the dura-mother that would lead to CVT complicating post spinal puncture headaches.</span>
<b><span style="font-family:Verdana;">Introduction: </span></b>Cerebral venous thrombosis (CVT) is a rare complication of spinal anesthesia. The diagnosis is difficult when it occurs by isolated headache, following post spinal puncture headache (PSPH). We report a case of cerebral venous thrombosis complicating PSPH, following <span>a spinal</span> anesthesia. <b><span>Observation:</span></b><span> A 23-year-old man was admitted to the emergency room for</span> PSPH appeared 6 hours after a spinal <span>aesthesia</span> for removal of osteosynthesis equipment from the<span style="font-family:Verdana;"></span><span style="font-family:;" "=""> right tibial plateau. The headache was <span>fronto</span>-occipital, relieved by lying down. Six days later, <span>headache</span> became permanent, not relieved by morphine, associated with vomiting. The neurological examination was normal. Brain magnetic resonance Magnetic venography showed superior sagittal sinus and right transverse sinus thrombosis. After administration of low molecular weight heparin at curative dose, and warfarin under INR control, the evolution was marked by a rapid regression of headaches on the same day. After a 1-year <span>setback,</span> the patient was asymptomatic. <b>Conclusion:</b> CVT is a rare complication of spinal anesthesia and potentially severe if diagnosed lately. Urgent brain imaging must be performed for any atypical headache or the onset of neurological disorders so as not to misunderstand cerebral vein thrombosis. Controlling the spine anesthesia would reduce the inadvertent perforation of the dura-mother that would lead to CVT complicating post spinal puncture headaches.</span>
作者
Raphael M. Kabore
Habib A. K. Ouiminga
Labodi Lompo
H. Desire Sankara
Anselme Dabilgou
Alassane Drave
Svetlana Barro Cherban
Christian Napon
Athanase Millogo
Jean Kabore
Raphael M. Kabore;Habib A. K. Ouiminga;Labodi Lompo;H. Desire Sankara;Anselme Dabilgou;Alassane Drave;Svetlana Barro Cherban;Christian Napon;Athanase Millogo;Jean Kabore(Department of Neurology, CHU Tengandogo, Ouagadougou, Burkina Faso;Department of Neurosurgery, CHU Tengandogo, Ouagadougou, Burkina Faso;Deparement of Imagery, CHU Tengandogo, Ouagadougou, Burkina Faso;Department of Neurology, CHU Yalgado OUEDRAOGO, Ouagadougou, Burkina Faso;Department of Neurology, CHU Ouahigouya, Ouahigouya, Burkina Faso;Department of Anesthesia-Reanimation, CHU Tengandogo, Ouagadougou, Burkina Faso;Department of Neurology, CHU Bogodogo, Ouagadougou, Burkina Faso;Department of Neurology, CHU-Souro SANOU, Bobo-Dioulasso, Burkina Faso)
