Hematoma subdural intracraniano: uma rara complicação após raquianestesia: relato de caso

Bisinotto, Flora Margarida Barra; Dezena, Roberto Alexandre; Fabri, Daniel Capucci; Abud, Tania Mara Vilela; Canno, Livia Helena

doi:10.1590/s0034-70942012000100012

Cited by 6 publications

(6 citation statements)

References 22 publications

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“…The incidence of intracranial subdural hematoma following lumbar puncture is estimated from 1:500,000 to 1,000,000. 1 However, according to other authors, 4 the actual incidence of subdural hematoma is unknown, and it may be higher than what is suggested by the few reported cases. Nonetheless, the rebleeding of a chronic subdural hematoma after spinal anesthesia is a very rare condition.…”

Section: Discussionmentioning

confidence: 90%

“…These same forces can stretch and rupture dural bridging veins, dural sinus walls or small cerebral cortical veins, with consequent hemorrhage and subdural hematoma development. 1 , 2 Intracranial hematomas are very common after severe trauma, but they can also occur following an unnoticed minor trauma, especially in elderly patients, who present intracranial space widening due to physiological atrophy of the brain. Non-traumatic causes are less common, such as ruptured aneurysms or cortical arteries, hypertensive cerebral hemorrhage, arteriovenous malformations, coagulopathies, use of anticoagulant or illicit drugs, and hypertensive disease during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…Manifestation changes, especially absence of posture correlation and longer duration, elicits the suspicion of other diagnoses, such as subdural hematoma. 1 , 2 Considering that few cases are reported in the literature and the potentially fatal progress of this neurological complication, signs suggesting the presence of intracranial hematoma need to be promptly recognized and appropriate treatment instituted. We aim to report the case of an obstetric patient presenting an undiagnosed chronic bilateral subdural hematoma, who presented chronic hematoma rebleeding after spinal anesthesia for cesarean delivery, and therefore draw attention to the need of thoroughly evaluating patients showing atypical postdural puncture headache.…”

Section: Introductionmentioning

confidence: 99%

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Intracranial rebleeding post spinal anesthesia in pregnant patient with undiagnosed chronic subdural hematoma: case report

Martins

Bisinotto

Dezena

et al. 2021

Brazilian Journal of Anesthesiology (English Edition)

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intracranial rebleeding post spinal anesthesia in pregnant patient with undiagnosed chronic subdural hematoma: case report

Martins

Bisinotto

Dezena

et al. 2021

Brazilian Journal of Anesthesiology (English Edition)

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“…Haviam sinais de desconforto ao se deitar (3-4 dias), leve ataxia de membros pél-vicos e hipotonia de cauda (10-15 dias). Uma das hipóteses que justificaria essa sensação de desconforto e aumento de sensibilidade seria a teoria fundamentada desde 1902 para humanos que qualifica os fenômenos álgicos como resultados da redução do volume liquórico e consequente tração das estruturas encefálica sensíveis à dor (Bisinotto et al 2012). Em todos os animais foram desprezadas três gotas de líquido cefalorraquidiano, entretanto a perda maior pode ter ocorrido pelo próprio orifício de punção na meninge aracnoide.…”

Section: Resultsunclassified

Eficácia e efeitos hemodinâmicos da anestesia raquidiana com ropivacaína isobárica, hipobárica ou hiperbárica em cães anestesiados com isofluorano

Abimussi

Floriano²,

Wagatsuma³

et al. 2017

Pesq. Vet. Bras.

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The aim of the study was to assess hemodynamic changes and complications of spinal anesthesia with ropivacaine at different baricities. Six beagle dogs aged four years. The dogs were anesthetized with isoflurane and subjected to the following treatments: G hypo = spinal anesthesia with hypobaric ropivacaine (0.5mL of 0.9% NaCl+0.5mL ropivacaine at 0.75%); G iso = isobaric spinal anesthesia (0.5mL of 0,906% NaCl+0.5mL ropivacaine at 0.75%); G hyper = hyperbaric spinal anesthesia (0.5mL of 10% glucose+0.5mL ropivacaine at 0.75%). After induction to anesthesia and maintenance with isoflurane, animals were positioned in right lateral recumbency for pulmonary artery catheterization through the left jugular vein. Spinal anesthesia was carried out with injection of 1mL of local anesthetic using a 22G Quincke tip needle in the L5-L6 space along 1 minute. Dogs were maintained under inhalation anesthesia for 60 minutes in ventral recumbency. HR, F R , MAP, CO, mPAP and body temperature progressively increased in all groups, whereas PCWP increased only in G HYPO at all time points. The TPRI showed significantly higher values in G ISO at M 1 , M 5 and M 10 compared to the other groups, except for M 5 , during which G ISO differed only from G HYPER . The PVRI increased at M 5 compared to M B in G ISO . Side effects such as unilateral motor deficit, bladder atony, excitation, acute pain and chemosis were observed. The hemodynamic changes were not relevant, although inhalation anesthesia with isoflurane might have influenced the results. The changes observed in the study demonstrate that motor blockade is likely to be obtained with isobaric and hyperbaric ropivacaine, thereby confirming the influence of baricity on the type of nerve fibers on the spinal cord. The isobaric solution results in a mixed blockade (motor and sensory blockade). Hemodynamic changes such as hypotension and bradycardia were not evidenced in this study, although local anesthetics were administered in low volumes and 1 Recebido em 21 de janeiro de 2016.Aceito para publicação em 7 de outubro de 2016.

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“…Certain complications of lumbar punctures are well known and documented, such as: headache, transient neurological disorders, subdural hematoma, abscesses, meningitis and encephalitis [3].…”

Section: Introductionmentioning

confidence: 99%

An Unusual Case of Herpes Simplex Meningitis after Inadvertent Puncture of the Subarachnoid Space

Vale¹,

Santiago²,

Neto³

et al. 2021

CRCM

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The study seeks to report the clinical evolution of a patient who suffered an inadvertent subarachnoid puncture and evolved with a herpetic viral meningitis, confirmed by cerebrospinal fluid (CSF) analysis. Female, 48 years old, submitted to epidural anesthesia, for surgery, with median puncture, between L2-L3 and inadvertently accessed the subarachnoid space, with clear cerebrospinal fluid. The same puncture was used and the solution with 15 mg hyperbaric bupivacaine and 80 mcg morphine was administered. There was no complication during the entire surgical procedure. On the first postoperative day, she started complaining of headache and nausea, being treated with dipyrone, non-steroidal anti-inflammatory drugs (NSAIDs) and ondansetron. On the third day, she presented two episodes of seizure that ceased with the use of diazepam 10 mg. On the fifth day, the patient presented fever and seizures, which did not stop with medication, requiring sedation, orotracheal intubation and transfer to the intensive care unit. Lumbar puncture was performed for CSF analysis, which was positive for Herpes simplex type I. The patient was extubated, on the second day of hospitalization, maintained with a maintenance dose of phenytoin, sumatriptan, dipyrone, metoclopramide and acyclovir 500 mg, remaining intravenous, without presenting new seizures for 45 days, when she was discharged. After 30 days, he returned for a review consultation without making a complaint.

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Hematoma subdural intracraniano: uma rara complicação após raquianestesia: relato de caso

Cited by 6 publications

References 22 publications

Intracranial rebleeding post spinal anesthesia in pregnant patient with undiagnosed chronic subdural hematoma: case report

Intracranial rebleeding post spinal anesthesia in pregnant patient with undiagnosed chronic subdural hematoma: case report

Eficácia e efeitos hemodinâmicos da anestesia raquidiana com ropivacaína isobárica, hipobárica ou hiperbárica em cães anestesiados com isofluorano

An Unusual Case of Herpes Simplex Meningitis after Inadvertent Puncture of the Subarachnoid Space

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