Intracranial subdural hematoma after spinal anesthesia.
Intracranial subdural hematoma is an exceptionally rare but life-threatening complication of spinal anesthesia. We report a case of intracranial subdural hematoma following spinal anesthesia for cesarean section in a 27-year-old woman. She developed a diffuse headache after surgery with a blood pressure of 220/140 mm Hg which was followed by generalized seizure activity. Her blood pressure remained high after medication with diazepam, nifedipine and magnesium sulfate. She remained unconscious with a Glasgow coma scale of 5. The cranial tomography revealed a subdural hematoma with diffuse cerebral edema and cerebral tentorial herniation. When a patient complains of postdural puncture headache and then has seizure activity, one should consider alternative diagnoses, including that of a subdural hematoma, and carry out a careful examination, including magnetic resonance imaging or computerized tomography scan.
Yildirim
G Berkel
GB
Department of Anesthesiology and Intensive Care, Dr. Lütfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey.
Colakoglu
S
S
Atakan
T Y
TY
Büyükkirli
H
H
D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D001921:Brain / Q000000981:diagnostic imaging; D005260:Female; D046648:Hematoma, Subdural, Intracranial / Q000209:etiology*; D006801:Humans; D011247:Pregnancy; D014057:Tomography, X-Ray Computed