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KMID : 0311120100510030475
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Yonsei Medical Journal
2010 Volume.51 No. 3 p.475 ~ p.477
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Subarachnoid and Intraventricular Hemorrhage due to Ruptured Aneurysm after Combined Spinal-Epidural Anesthesia
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Chun Duk-Hee
Kim Na-Young
Shin Yang-Sik
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Abstract
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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.
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KEYWORD
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Aneurysm rupture, spinal anesthesia, subarachnoid hemorrhage
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