Cerebral Subdural Hematoma Following Spinal Anesthesia: Report of Two Cases

Moradi, Mehrdad; Shami, Shoaleh; Farhadifar, Fariba; Nesseri, Karim

doi:10.1155/2012/352028

Cited by 25 publications

(37 citation statements)

References 20 publications

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“…Chronic subdural hematomas after puncture of the spinal dura have been previously reported following spinal anesthesia. Moradi et al 7) reported that intracranial hypotension from CSF leakage after dural puncture can lead to a caudal shift of the brain, with subsequent traction on the arachnoid membrane and dural veins. This damages the blood vessels, which could result in blood leakage and the formation of a subdural hematoma.…”

Section: Discussionmentioning

confidence: 99%

Intracranial Chronic Subdural Hematoma Presenting with Intractable Headache after Cervical Epidural Steroid Injection

Kim

Park

2015

J Korean Neurosurg Soc

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Postdural punctural headache (PDPH) following spinal anesthesia is due to intracranial hypotension caused by cerebrospinal fluid (CSF) leakage, and it is occasionally accompanied by an intracranial hematoma. To the best of our knowledge, an intracranial chronic subdural hematoma (CSDH) presenting with an intractable headache after a cervical epidural steroid injection (ESI) has not been reported. A 39-year-old woman without any history of trauma underwent a cervical ESI for a herniated nucleus pulposus at the C5-6 level. One month later, she presented with a severe headache that was not relieved by analgesic medication, which changed in character from being positional to non-positional during the preceding month. Brain magnetic resonance imaging revealed a CSDH along the left convexity. Emergency burr-hole drainage was performed and the headache abated. This report indicates that an intracranial CSDH should be considered a possible complication after ESI. In addition, the event of an intractable and changing PDPH after ESI suggests further evaluation for diagnosis of an intracranial hematoma.

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Section: Discussionmentioning

confidence: 99%

Intracranial Chronic Subdural Hematoma Presenting with Intractable Headache after Cervical Epidural Steroid Injection

Kim

Park

2015

J Korean Neurosurg Soc

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“…Clinical manifestations ranging from alterations in headache from postural to non-postural, vomiting, diplopia, cognitive changes, changes in consciousness level, focal neurological signs like ptosis, paresis, weakness, and language deficits are also noted. 2,4,5 The period of headache triggered by subdural hematoma is categorized into three patterns. The first pattern, which is the most common, is a headache that presents early (within four days) after dural puncture and lingers with subsequent onset of subdural hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

“…3 Due to unknown reasons, cerebral subdural hemorrhage after spinal anesthesia occurs more regularly on the left side, as early as six hours and at the latest by twenty-nine weeks. 5 Risk factors for the emergence of subdural collections are cerebral atrophy, cerebral aneurysms, blood dyscrasias, platelet anti-aggregation drugs, arteriovenous malformations, pregnancy, dehydration, alcohol consumption, multiple punctures, thick bore needles, epidural needles, and fenestrations from previous punctures. 5,6,7 Spinal anesthesia performed with fine needles of the Whitacre-, Sprotte-and Atraucan-type bevel have not been reported to prevent this complication.…”

Section: Discussionmentioning

confidence: 99%

Post-Lumbar Puncture Chronic Intracranial Subdural Hematoma

Mathew

Abraham

2019

ijihs

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Objective: To desribe a case of cranial subdural hematoma as an atypically sporadic and potentially devastating complication of a lumbar puncture mimicking post-dural puncture headache which may lead to delayed diagnosis. Method: This is a a case report of chronic intracranial subdural hematoma as a complication of lumbar puncture for spinal anaesthesia in a forty-eight-year-old male underwent an uneventful ureterolithotomy. In the postoperative period, the patient complained of excruciating headache which partially subsided with symptomatic treatment. However, after four weeks, the patient presented with worsening headache and vomiting. Results: A contrast enhanced computer tomography study revealed a subdural haematoma in the left fronto-temporo-parietal-region. The patient underwent an immediate decompressive craniectomy for subdural hematoma. The postoperative period was uneventful and the patient was discharged without any neurological deficits. Conclusion: Intracranial complication such as subdural hematoma is rare after a dural puncture and is often masquerading as a post dural puncture headache. Imaging studies like computerized tomography and magnetic resonance imaging are to be considered in earlier stages of non-retractable headache to rule out such rare complications.

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“…The primary pathophysiology of this complication is unknown; however, there are some data that it is the same as PLPH, with some minor differences. Intracranial hypotension allows a caudal shift of the brain, with traction on the arachnoid mater and dural veins; this leads to lesions of the blood vessels and could result in blood extravasations and formation of SDH [3,12].…”

Section: Criteria Of Post-lumbar Puncture Headache According To Ichd-3mentioning

confidence: 99%