Intracranial hygroma is a rare and probably missed complication of epidural analgesia secondary to accidental dural breech. The patient presented had a presumed spinal cerebrospinal fluid leak with symptoms of intracranial hypotension. Unusually the patient had both an intracranial subdural hygroma and rarely reported extensive spinal intradural (extra-arachnoid) collection following a lumbar epidural, administered in labour. Given the potential for progression to symptomatic neurological deficits, anesthetists should consider subdural hygroma when encountering patients with features of intracranial hypotension, or altered neurology following epidural. Pathophysiology, imaging and management are discussed.

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This chapter provides a comprehensive review of the presentation, investigation, and management of patients presenting with a spinal infection. Particular attention is given to discitis and osteomyelitis (collectively referred to as spondylodiscitis), spinal epidural abscesses, and postoperative infections following spine surgery, although in practice there is considerable overlap between these conditions. These forms of spinal infection are rare, but are associated with significant morbidity and mortality, often due to diagnostic delays related to their non-specific presenting symptoms. The relevant literature is reviewed and summarized to provide guidance on the prompt diagnosis and management of these conditions in clinical medical practice.