Subarachnoid and Intraventricular Hemorrhage due to Ruptured Aneurysm after Combined Spinal-Epidural Anesthesia.
10.3349/ymj.2010.51.3.475
- Author:
Duk Hee CHUN
1
;
Na Young KIM
;
Yang Sik SHIN
Author Information
1. Department of Anesthesiology & Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. ysshin@yuhs.ac
- Publication Type:Case Report
- Keywords:
Aneurysm rupture;
spinal anesthesia;
subarachnoid hemorrhage
- MeSH:
Aged;
Anesthesia, Epidural/*adverse effects;
Anesthesia, Spinal/*adverse effects;
Aneurysm, Ruptured/*chemically induced/*complications;
Cerebral Ventricles/*physiopathology;
Humans;
Intracranial Hemorrhages/*etiology;
Male;
Subarachnoid Hemorrhage/*etiology
- From:Yonsei Medical Journal
2010;51(3):475-477
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 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.
