Effect of continuous epidural saline infusion to the cerebrospinal fluid hypovolemia occurring in after-stretching exercise

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  • MURATA Yuya
    Department of Anesthesiology, University of Tsukuba Hospital
  • INOMATA Shinichi
    Department of Anesthesiology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba
  • YAMAGUCHI Tetsuto
    Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba
  • WATANABE Masahiko
    Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba
  • TAMAOKA Akira
    Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba
  • TANAKA Makoto
    Department of Anesthesiology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba

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Other Title
  • ストレッチ動作後に生じた脳脊髄液減少症に対する硬膜外腔への生理食塩液持続投与の効果
  • 症例 ストレッチ動作後に生じた脳脊髄液減少症に対する硬膜外腔への生理食塩液持続投与の効果
  • ショウレイ ストレッチ ドウサ ゴ ニ ショウジタ ノウ セキズイエキ ゲンショウショウ ニ タイスル コウマク ガイコウ エ ノ セイリ ショクエンエキ ジゾク トウヨ ノ コウカ

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Abstract

A 26-year-old woman patient, previously healthy, is an airline stewardess. On a recent fl ight, after lifting some heavy passenger baggage in her duties to the overhead shelf by using the power of her whole body, she felt nausea and headache. They both increased that evening and in a standing position, but improved in a supine position. Spinal fluid leakage was observed by her computed tomography (CT) -myelography, and she was diagnosed with cerebrospinal fluid hypovolemia (CFH). We performed a continuous epidural saline infusion as treatment to her, and her symptoms and activities of daily living improved. It was then possible for us to treat CFH safely and effectively without epidural autologous blood infusion, which is well-known and can have many complications. Also, though the pathogenesis of CFH in a nontraumatic case is unknown, stretching exercises such as lifting heavy baggage overhead possibly caused CFH in this case.

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