Cerebral subarachnoid blood migration consecutive to a lumbar haematoma after spinal anaesthesia

Hans, Grégory; Sénard, Marc; Ledoux, Didier; Grayet, Benjamin; Scholtes, Félix; Creemers, Etienne; Lamy, Maurice

doi:10.1111/j.1399-6576.2008.01648.x

Cited by 9 publications

(11 citation statements)

References 6 publications

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“…Headache in pregnancy also includes pre‐eclampsia, migraine, drug‐induced headache and intracranial pathologies. Intracranial pathologies include subdural hygromas and hematomas, intracerebral haemorrhaging and venous sinus thrombosis . In the event of subdural hygromas or hematomas, which act as mass lesions, presentation may range from mild confusion and drowsiness to unstable gait, severe headache and grand mal convulsion …”

Section: Discussionmentioning

confidence: 99%

“…Other rare complications include subarachnoid and intraparenchymal bleeding, cortical vein thrombosis or intraspinal puncture combined with cerebral subarachnoid haemorrhaging . The emergence of a cranial subarachnoid haemorrhage after a postdural puncture is a rare complication with no clear production mechanisms, which are multifactorial.…”

Section: Discussionmentioning

confidence: 99%

“…During labour, she was monitored and no high arterial pressure was recorded. Infrequent intracranial subarachnoid haemorrhages after lumbar puncture are often associated with the breaking of intracranial aneurysms, arteriovenous malformations or vessel damage as a result of low intracranial pressure and traction of the brain in relation to arachnoid or perianaesthesia stress, whose pathogenesis is unclear . Although no arteriovenous malformations or aneurysms were found in the CCT or cranial MRI, the presence or absence of any vascular abnormalities cannot be confirmed because cerebral arteriography was not performed.…”

Section: Discussionmentioning

confidence: 99%

“…Very few reports describe intracranial haemorrhages after dural puncture and most are subdural hematomas. It was not possible to confirm if the subarachnoid and intraparenchymal haemorrhages were complications of postdural puncture by CSF hypotension, isolated hypertension, perianaesthesia stress, or if they were already existed …”

Section: Discussionmentioning

confidence: 99%

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Subdural hygroma accompanied by parenchymal and subarachnoid haemorrhage after epidural analgesia in an obstetric patient

del-Río-Vellosillo

García-Medina

Fernandez-Rodriguez

et al. 2014

Acta Anaesthesiol Scand

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Subdural hygroma accompanied by parenchymal and subarachnoid haemorrhage after epidural analgesia in an obstetric patient

del-Río-Vellosillo

García-Medina

Fernandez-Rodriguez

et al. 2014

Acta Anaesthesiol Scand

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“…Additionally, vascular malformations and spinal tumors have also been reported to cause SSH 1 , 2 , 3) . In rare cases, SSH can spread into the intracranial subarachnoid space because of its connection to each other 3 , 4 , 7 , 8 , 10 , 11 , 13) . However, severe cerebral vasospasm has rarely been reported as a complication of intracranial subarachnoid hemorrhage (SAH) from SSH 3) .…”

Section: Introductionmentioning

confidence: 99%

Intracranial Extension of Spinal Subarachnoid Hematoma Causing Severe Cerebral Vasospasm

Nam

Lee

Choi

et al. 2014

J Korean Neurosurg Soc

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Spinal subarachnoid hemorrhages (SAH) can extend into the intracranial subarachnoid space, but, severe cerebral vasospasm is rare complication of the extension of intracranial SAH from a spinal subarachnoid hematoma. A 67-year-old woman started anticoagulant therapy for unstable angina. The next day, she developed severe back pain and paraplegia. MRI showed intradural and extramedullar low signal intensity at the T2-3, consistent with intradural hematoma. High signal intensity was also noted in the spinal cord from C5 to T4. We removed subarachnoid hematoma compressing the spinal cord. The following day, the patient complained of severe headache. Brain CT revealed SAH around both parietal lobes. Three days later, her consciousness decreased and left hemiplegia also developed. Brain MRI demonstrated multiple cerebral infarctions, mainly in the right posterior cerebral artery territory, left parietal lobe and right watershed area. Conventional cerebral angiography confirmed diffuse severe vasospasm of the cerebral arteries. After intensive care for a month, the patient was transferred to the rehabilitation department. After 6 months, neurologic deterioration improved partially. We speculate that surgeons should anticipate possible delayed neurological complications due to cerebral vasospasm if intracranial SAH is detected after spinal subarachnoid hematoma.

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Transient paraplegia due to subarachnoid haemorrhage following spinal anaesthesia

Olivei

Giachetti

et al. 2020

Anaesthesia Reports

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Spinal subarachnoid haemorrhage is a rare complication of spinal anaesthesia, especially following atraumatic lumbar puncture and in the absence of coagulopathies. The initial presentation of spinal subarachnoid haemorrhage is variable and paraplegia with full recovery within a few hours is rare. Bleeding can extend into the intracranial subarachnoid space, but there are only a few reports of symptomatic intracranial and spinal subarachnoid haemorrhage after spinal anaesthesia. We report co-existing spinal subarachnoid haemorrhage and intracranial subarachnoid haemorrhage after atraumatic spinal anaesthesia in a 69-year-old woman without a coagulopathy. The day after surgery she developed flaccid paraplegia that spontaneously resolved in a few hours. Magnetic resonance imaging demonstrated subarachnoid high signal intensity from T11-S2, consistent with spinal subarachnoid haemorrhage. On the same day the patient complained of severe headache which was later followed by diplopia. Neurological imaging studies revealed diffuse distribution of blood in the subarachnoid space but no intracranial vascular malformations. At the time of diagnosis spontaneous recovery of spinal symptoms had already begun and the clinical manifestations eventually resolved with conservative management. The possibility of an intracranial haemorrhage should always be considered when spinal subarachnoid haemorrhage is identified, even in cases of uncomplicated spinal anaesthesia in patients with no known risk factors for spinal haemorrhage.

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Cerebral subarachnoid blood migration consecutive to a lumbar haematoma after spinal anaesthesia

Cited by 9 publications

References 6 publications

Subdural hygroma accompanied by parenchymal and subarachnoid haemorrhage after epidural analgesia in an obstetric patient

Subdural hygroma accompanied by parenchymal and subarachnoid haemorrhage after epidural analgesia in an obstetric patient

Intracranial Extension of Spinal Subarachnoid Hematoma Causing Severe Cerebral Vasospasm

Transient paraplegia due to subarachnoid haemorrhage following spinal anaesthesia

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