Postpartum bilateral subdural hematomas following spinal anesthesia: case report.
BACKGROUND
Intracranial subdural hematoma is an exceptionally rare complication of spinal anesthesia. We report a case of this infrequent event and consider the influence of cerebral atrophy as a predisposing factor.


RESULTS
This 18-year-old woman with severe headaches was admitted to the hospital 42 days after delivery. She had a history of normal pregnancy and uneventful labor and delivery. The epidural anesthesia was satisfactory. Computed tomography showed bilateral chronic subdural hematomas that were surgically removed. An early follow-up scan showed marked resolution of the hematomas and a small sized brain with large subarachnoid space. A late follow-up scan confirmed the diagnosis of brain atrophy.


CONCLUSIONS
Persistence of headache and gradual progression despite treatment must be regarded as a sign of intracranial complication following spinal anesthesia. In this case, cerebral atrophy is considered to be a contributory factor for the development of subdural hematoma following dural puncture.
Cohen
J E
JE
Department of Neurosurgery, Hospital de Emergencias Dr. Clemente Alvarez, Rosario, Argentina.
Godes
J
J
Morales
B
B
D000293:Adolescent; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D001284:Atrophy / Q000150:complications / Q000175:diagnosis; D001921:Brain / Q000473:pathology*; D015984:Causality; D003937:Diagnosis, Differential; D005260:Female; D006408:Hematoma, Subdural / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D011247:Pregnancy; D011644:Puerperal Disorders / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D014057:Tomography, X-Ray Computed