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Yonsei medical journal · May 2010
Case ReportsSubarachnoid and intraventricular hemorrhage due to ruptured aneurysm after combined spinal-epidural anesthesia.
- Duk-Hee Chun, Na-Young Kim, and Yang-Sik Shin.
- Department of Anesthesiology & Pain Medicine, Anesthesia & Pain Research Institute, Yonsei University College of Medicine, 250 Seongsan-ro, Seodaemun-gu, Seoul 120-752, Korea.
- Yonsei Med. J. 2010 May 1;51(3):475-7.
AbstractA patient received combined spinal-epidural anesthesia for a scheduled total knee arthroplasty. After an injection of spinal anesthetic and ephedrine due to a decrease in blood pressure, the patient developed a severe headache. The patient did not respond to verbal command at the completion of the operation. A brain CT scan revealed massive subarachnoid and intraventricular hemorrhages, and a CT angiogram showed a ruptured aneurysm. Severe headaches should not be overlooked in an uncontrolled hypertensive patient during spinal anesthesia because it may imply an intracranial and intraventricular hemorrhage due to the rupture of a hidden aneurysm.
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