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

Bakar, Bülent; Özer, Esra Arun; Tekkök, İsmail H.

doi:10.1016/j.bjane.2013.07.002

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…Symptomatic seizure after spinal anesthesia [15,16], combined spinal-epidual anesthesia [17], and accidental dural puncture during epidural anesthesia [18,19] have previously been reported. In these cases, intracranial hemorrhage after spinal and epidural anesthesia led to seizure.…”

Section: Discussionmentioning

confidence: 96%

A case report of seizure during emergence from general anesthesia after lumbar spinal surgery—common cases can develop potentially life-threatening adverse intracranial events

et al. 2018

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Background: Adverse intracranial events after spinal surgery were related with intracranial hypotension due to surgical injury of dura mater. Case presentation: A 72-year-old woman received posterior lumbar interbody fusion under general anesthesia. Immediately after the patient was transitioned to the supine position and muscular relaxants were reversed, she developed generalized seizure. The seizure was immediately suppressed with propofol. Brain computed tomography was unremarkable. Although she returned to the surgical suite, an evident point of dural laceration was not found. The dura was covered with fibrin glue. Magnetic resonance imaging revealed subarachnoid hemorrhage (SAH) on postoperative day 1. By postoperative day 2, the seizure had resolved. The cause of her seizure was suspected to be SAH due to intracranial hypotension. Seizure was masked by ongoing anesthesia and muscle relaxation. Conclusions: Although spinal surgeries are common procedure, we must carefully consider its related potentially life-threatening adverse events.

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Section: Discussionmentioning

confidence: 96%

A case report of seizure during emergence from general anesthesia after lumbar spinal surgery—common cases can develop potentially life-threatening adverse intracranial events

et al. 2018

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The use of neuraxial blockades in obstetric practice for thrombocytopenia

Плахотина¹,

Belousova²,

Kuzina³

2019

Innovacionnaâ medicina Kubani

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Thrombocytopenia is the second most frequent hematological complica-tion of pregnancy after anemia. Among all thrombocytopenia during pregnancy, the most common is gestational thrombocytopenia. Gestational thrombocytopenia is not accompanied by coagulation disorders, has a minimal risk of bleeding, for both a mother and her fetus. Nevertheless, according to modern concepts, thrombocytopenia is a contraindication for performing obstetric neuroaxial blockades only on the basis of quantitative count of platelets, without taking into account coagulation status. These contraindications are derived from the general surgery and traumatology practice due to the high risk of developing epidural hematoma, but do not take into account the features, including physiological hypercoagulation, of pregnant patients. Refusal of the patient to perform a neuroaxial blockade during delivery on the basis of only counting the number of platelets often leads to an unreasonable increase in the risk / benefit ratio for both the mother and the fetus. Analysis of the research results indicates a change in attitude towards this problem towards a more loyal approach, taking into account the assessment of the coagulative status of a particular patient.

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

Abstract: As conclusion, with the use of this combined spinal-epidural anaesthesia, it should be kept in mind that headache does not always mean low pressure headache associated with spinal anaesthesia and that a catastrophic complication of subdural haematoma may also occur.

Cited by 2 publications

References 7 publications

A case report of seizure during emergence from general anesthesia after lumbar spinal surgery—common cases can develop potentially life-threatening adverse intracranial events

A case report of seizure during emergence from general anesthesia after lumbar spinal surgery—common cases can develop potentially life-threatening adverse intracranial events

The use of neuraxial blockades in obstetric practice for thrombocytopenia

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