Cell, Gene and Therapy Journal

Peer-reviewed multi-disciplinary and Open Access journal accepts scientifically rigorous research, regardless of novelty

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Subdural hematoma as a complication of Spinal Anesthesia

Shahbeigi Saeed1, Parian Parisadat*2, Nekutalaban Parham3, keyhanifard majid4
1 Brain Mapping Research Centre, Shahid Beheshti University, Neuroscience Research Centre, Iran University of Medical Sciences.
2 Medical Doctor, Semnan University of Medical Sciences, Semnan, Iran.
3 Student Research committee, Qom university of Med ical Science, Qom, Iran.
4 Neuro_intervention Department, Baghiatollah Hospital

Subdural hematoma (SDH) is a rare but important sequel of spinal anesthesia. We present a case of intracranial SDH in a lady developing headache after Cesarean section. A 34-years-old primigravida at 39 weeks of pregnancy was scheduled as an elective Cesarean section (c/s). She had no significant problems and also the pregnancy was done without any complications. The spinal anesthesia was given at L3-4 level by 25 G Quincke needle. Dural puncture was done well and was atraumatic. Two hours after delivery the headache had begun. That was on the frontal area with no other symptoms such as nausea and vomiting, confusion and loss of consciousness.
She received Corticosteroid and then her headaches improved relatively but a few hours after discharge, she developed a frontotemporal headaches, that was became more and more and in about one month, she had headaches almost every day. After two months, she suddenly experienced much more severe headache with the left side paresthesia and numbness. She referred to a hospital. On the admission, the ophthalmological and neurological exams were done. Ophtalmological exams were normal. The brain MRI revealed a small SDH in the right frontal region without pressure effect. The results of her lab data were totally in normal range. We found that the spinal analgesia could be the only possibility of SDH. On the sequential follow up brain MRI, the SDH was completely resolved and her headaches were abolished as well.
Conclusion: It is recommended when the patient has a persistent and prolonged headaches or a changed character one after doing lumbar puncture, SDH should be considered as a serious complication, just like the aforementioned case.

Keywords : Post-Dural Puncture Headache, SDH, Anesthesia, Spinal Complications, Hematoma, Subdural


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