Epidural blood patch for spontaneous intracranial hypotension with chronic subdural haematoma: A case report and literature review

Zhang, Jian; Jin, Dan; Pan, Kong-Han

doi:10.1177/0300060516645955

Cited by 20 publications

(18 citation statements)

References 28 publications

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“…In the present case, epidural blood patch was administered for the treatment of CSDH. Various treatments for CSDH after PDPH have been reported including observation, surgical resection of the hematoma, epidural blood patch, or both surgical resection and epidural blood patch [ 7 , 8 , 18 , 19 ]. The treatment plan is decided according to the patient’s neurological symptoms and the size of the hematoma.…”

Section: Discussionmentioning

confidence: 99%

A case report of intracranial hemorrhage after spinal anesthesia

2017

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BackgroundChronic subdural hematoma (CSDH) after spinal anesthesia is a rare complication. We experienced a patient who developed CSDH after postdural puncture headache (PDPH) following combined spinal and epidural anesthesia (CSE).Case presentationA 38-week-gestation parturient with a history of previous cesarean delivery underwent elective cesarean section under CSE. She had been receiving aspirin therapy for Kawasaki disease for many years. She developed a symptom of PDPH 1 day after the surgery. Fluid administration and analgesics were started. Although the headache was relatively severe and persistent, it suddenly disappeared on the third postoperative day. Aspirin administration was restarted on the third postoperative day, and the patient was discharged 1 week after the surgery. 2 weeks after being discharged, she was readmitted to our hospital for severe headache and was diagnosed as having CSDH. An epidural blood patch was performed, resulting in resolution of the hematoma.ConclusionsWe experienced a case of CSDH after PDPH in a patient who was receiving aspirin therapy. Aspirin therapy should be restarted after confirmation of the absence of headache. We should consider the possibility of unexpected disappearance of PDPH in the postoperative period may be due to the development of CSDH.

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Section: Discussionmentioning

confidence: 99%

A case report of intracranial hemorrhage after spinal anesthesia

2017

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“…EBP was performed shortly after the evacuation, minimizing the potential for re-bleeding, and since she had a ventricular drain placed, there was little risk of causing increased intracranial pressure with EBP. As noted in a similar case, delay in EBP after craniotomy can lead to a clinical deterioration (1,11).…”

Section: Discussionmentioning

confidence: 71%

Thoracic Epidural Blood Patch Improves Neurologic Symptoms Following Surgical Evacuation of Bilateral Subdural Hematomas: A Case Report

Dorbad¹

2017

PMCR

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“…The main clinical differences with intracranial hypotension were the location of the headache (frontal vs. occipital), the worst position (recumbent vs. upright), and the degree of nausea and blurred vision (severe vs. mild or absent) 21 . Epidural blood patches have been used safely in spontaneous intracranial hypotension with subdural hematoma 22 …”

Section: Discussionmentioning

confidence: 99%

Post‐Dural Puncture Headache Evolving to a Subdural Hematoma: A Case Report

Dehaene

Biesemans²,

Boxem

et al. 2020

Pain Practice

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IntroductionCervical epidural corticosteroid injections are frequently used for the treatment of subacute cervicobrachial pain. This therapy is considered safe, with the vast majority of the complications being minor and transient.Case ReportWe present a case of a woman in her fifties who suffered from cervicobrachialgia and received 2 cervical epidural corticosteroid infiltrations. On day 3 after the second infiltration, a new headache appeared and on day 16 a bilateral subdural hematoma was visualized on CT scan. Complete resorption of the hematoma was seen on day 25 without surgical intervention.DiscussionUp until now, only 1 case report of an intracranial subdural hematoma after a cervical epidural steroid injection has been published. But several cases of an intracranial subdural hematoma after spinal, epidural, or combined spinal and epidural anesthesia have been reported. Physicians should be aware of this potentially dramatic complication since post‐dural puncture headache after any type of procedure can evolve into a subdural hematoma. Clinical differentiation between the two can be difficult; post‐dural puncture headache is characterized by relief of symptoms in the supine position and photophobia/phonophobia. A subdural hematoma should be considered if the headache changes in character, does not respond to treatment, or there are neurological signs such as nausea/vomiting and blurred vision. Immediate medical imaging should then be performed.

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Epidural blood patch for spontaneous intracranial hypotension with chronic subdural haematoma: A case report and literature review

Cited by 20 publications

References 28 publications

A case report of intracranial hemorrhage after spinal anesthesia

A case report of intracranial hemorrhage after spinal anesthesia

Thoracic Epidural Blood Patch Improves Neurologic Symptoms Following Surgical Evacuation of Bilateral Subdural Hematomas: A Case Report

Post‐Dural Puncture Headache Evolving to a Subdural Hematoma: A Case Report

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