Postdural puncture subdural hematoma or postdural puncture headache?: two cases report

Kale, Aydemir; Emmez, Hakan; Pişkin, Özcan; Durdağ, Emre

doi:10.4097/kjae.2015.68.5.509

Cited by 19 publications

(20 citation statements)

References 16 publications

(28 reference statements)

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“…In several cases, administration of antiplatelets or anticoagulants had been suspected to be related to the development of PDPH [ 8 – 10 ]. Landman et al [ 9 ] reported a case of CSDH in a patient who had self-administered aspirin and caffeine for the treatment of PDPH.…”

Section: Discussionmentioning

confidence: 99%

“…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%

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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%

Section: Discussionmentioning

confidence: 99%

A case report of intracranial hemorrhage after spinal anesthesia

2017

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“…Prognosis is good if diagnosed early and managed timely. [6][7][8] In our patient, CSF loss following ADP resulted in PDPH. For the initial one week of PDPH the headache was mainly postural.…”

Section: Discussionmentioning

confidence: 56%

“…The exact incidence of postdural puncture subdural hematoma (PDPSH) is unknown because of its rarity and also because many such patients are probably managed with conservative line of treatment without any further investigation believing it to be simple PDPH. 6 This is essentially because of the similarities with the sign and symptoms of PDPH with PDPSH. Patients of PDPSH have been successfully managed conservatively as well as by surgical evacuation of the hematoma.…”

Section: Introductionmentioning

confidence: 99%

Subdural Hematoma following Accidental Dural Puncture while Performing Epidural Analgesia - A Case Report

Aldhahri¹,

Khan²,

Kaul³

et al. 2019

IJCMR

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Introduction: Subdural hematoma is a rare but serious complication of accidental dural puncture during epidural or spinal anesthesia. This case report emphasizes the importance of close follow-up of patients with post dural puncture headache following accidental dural puncture and methods to identify development of subdural hematoma in such patients.Case report: a 23-year-old healthy primigravida developed accidental dural puncture while trying to locate epidural space using a Tuohy needle for painless labor. The patient complained of headache on the 2 nd post-operative day that was significantly relieved by analgesics, bed rest and hydration. Later she presented with severe headache that became persistent and lost its correlation with change of posture. Other than feeling nauseated she had no other additional signs and symptoms. Diagnosis of the SDH was confirmed via CT and treated surgically. The patient recovered completely. Conclusion:One should consider the possibility of subdural hematoma in patients when postdural puncture headache is prolonged or has a change in the character of headache with or without neurological symptoms for an early successful intervention.

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“…The time course in the present case was similar to that in a patient reported by Macon et al who did not present a remarkable headache before the development of SDH [ 6 ]. In most patients who developed SDH, a headache presented before the development of SDH [ 4 , 7 , 8 ]. The most important finding in the present case is that SDH developed in a patient who did not have a headache after ADP using a Tuohy needle.…”

Section: Case Presentationmentioning

confidence: 99%

Subdural hematoma after cesarean delivery without symptoms: a case report

Domoto

Suzuki

et al. 2018

JA Clin Rep

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BackgroundSubdural hematoma (SDH) after accidental dural puncture (ADP) is rare but may be lethal. We experienced a patient who developed SDH after combined spinal and epidural anesthesia without a headache.Case presentationA 41-year-old parturient female with an unruptured cerebral aneurysm, was scheduled to undergo elective cesarean delivery. Cerebrospinal fluid leakage was identified during puncture of the epidural space, and a catheter was placed after re-puncture. The postoperative course was normal except for incisional pain. The patient complained of slight neck stiffness on the second postoperative day. Magnetic resonance imaging (MRI) was performed to ensure that there was no intracranial problem on the fourth postoperative day and showed a bilateral subdural hematoma. Increase in size of hematoma was shown on computed tomography (CT) on the ninth postoperative day. Epidural blood patch was performed. A decrease in the size of the hematoma was confirmed on the CT images on the 11th postoperative day, and the patient was discharged. The patient has not developed any additional symptoms.ConclusionsWe experienced a patient who developed a SDH without a remarkable headache. It may be better to perform brain imaging studies, even if the patient does not complain of headache.

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Postdural puncture subdural hematoma or postdural puncture headache?: two cases report

Cited by 19 publications

References 16 publications

A case report of intracranial hemorrhage after spinal anesthesia

A case report of intracranial hemorrhage after spinal anesthesia

Subdural Hematoma following Accidental Dural Puncture while Performing Epidural Analgesia - A Case Report

Subdural hematoma after cesarean delivery without symptoms: a case report

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