Affiliation:
1. Department of Anaesthesiology, B. J. Govt. Medical College, Pune, Maharashtra, India
Abstract
Intracranial bleed in the form of subdural hematoma (SDH) with intracranial hypotension after spinal anesthesia for cesarean section is a rare condition with an incidence of around 1 in 5,00,000 obstetric populations. As its presentation is similar to post-dural puncture headache (PDPH), it can be misdiagnosed sometimes. Persistent headache for more than 5 days, vomiting, blurring of vision, and convulsion can guide the diagnosis of intracranial bleed. Magnetic resonance imaging (MRI) helps to diagnose the location, size, and other abnormalities of bleed in such patients. The management ranges from conservative to surgical management in the form of craniotomy. Here, we present a case of a 19-year-old woman, who operated on for cesarean section under spinal anesthesia presented with SDH and intracranial hypotension on postoperative day (POD) 6. She was managed conservatively with plenty of intravenous (IV) fluids, bed rest, low head position, analgesics, and antiepileptics. A repeat computed tomography (CT) scan was performed after 14 days, which showed resolved SDH, and the patient was discharged.
Subject
Anesthesiology and Pain Medicine
Reference13 articles.
1. Serious non-fatal complications association with extradural block in Obstetric Practice;Scott;Obstetric Anesthesia Digest,1990
2. Acute subdural hematoma after spinal anesthesia in an obstetric patient;Ramos-Aparici;J Clin Anesth,2008
3. Acute subdural hematoma after spinal anesthesia in an obstetric patient;Ramos-Aparici;J Clin Anesth,2008
4. Intracerebral haematoma following spinal anaesthesia for caesarean section: Case report;Ulivieri;G Chi,2009
5. Síndrome de hipotensión endocraneana: ¿Una cefalea pospunción dural?;Quintero;Revista Colombiana de Anestesiología,2013