Life-threatening acute subdural haematoma after combined spinal-epidural anaesthesia in labour

Brazilian Journal of Anesthesiology
Bulent BakarIsmail Hakki Tekkok

Abstract

Only few reports in literature have pointed out to the possibility of a cranial subdural haematoma formation associated with dural puncture during spinal or epidural analgesia. We herein describe such a rare case who was diagnosed to have acute subdural haematoma after combined spinal-epidural anaesthesia used in labour. A 34-year-old, primigravid women with a gestation of 38 weeks underwent caesarean section under combined spinal-epidural anaesthesia and gave birth to a healthy boy. Thirty-two hours after delivery, her moderate headache progressed to a severe headache associated with nausea and vomiting and later was more complicated with a generalized tonic-clonic seizure and ensuing lethargy. Computed tomography of the brain demonstrated a right-sided fronto-temporo-parietal acute subdural haematoma with diffuse cerebral oedema. She underwent urgent FTP craniotomy and evacuation of the haematoma. Early postoperative cranial computed tomography showed a clean operative site. Eight days after subdural haematoma surgery, she became lethargic again, and this time cranial computed tomography disclosed an extradural haematoma under the bone flap for which she had to undergo surgery again. Two days later, she was discharged home wi...Continue Reading

References

May 24, 2000·British Journal of Anaesthesia·D J VaughanP N Robinson
Aug 24, 2004·International Journal of Obstetric Anesthesia·N KayacanM Erman
Sep 2, 2008·Journal of Clinical Anesthesia·Rocio Ramos-ApariciMiguel Vila-Sánchez
Jan 18, 2012·Revista brasileira de anestesiologia·Flora Margarida Barra BisinottoLivia Helena Canno

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