title: Bilateral subdural hematoma after inadvertent dural puncture during epidural analgesia.
abstract: BACKGROUND
  Post-dural puncture headache (PDPH) is typically a benign complication of dural puncture that is clinically diagnosed. It commonly presents as a throbbing and positional headache that occurs 24-48 h after dural puncture. Subdural hematomas, if unrecognized, may occur as a rare and life-threatening complication of dural puncture.
  
  
  OBJECTIVE
  We aim to describe the clinical features and sequelae of a rare complication that may result as a consequence of inadvertent dural puncture that, if unrecognized, has the potential to become a life-threatening complication from a common procedure.
  
  
  METHODS
  We report the case of a previously healthy 17-year-old primigravida female who initially presented 4 days postpartum with clinical features and imaging studies consistent with PDPH. The patient's symptoms were unremitting, and within 4 weeks, she developed bilateral subdural hematoma. With prompt recognition and diagnosis, she was treated with conservative medical management and subsequently improved on follow-up.
  
  
  CONCLUSIONS
  Patients with unremitting PDPH should prompt the clinician to suspect the development of subdural hematoma as a potential life-threatening complication of an otherwise benign condition.
authors.affiliation: University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Roman
authors.initials: R
authors.lastname: Nepomuceno
authors.forename: Anthony
authors.initials: A
authors.lastname: Herd
mesh_terms: D000293:Adolescent; D015360:Analgesia, Epidural / Q000009:adverse effects*; D016362:Analgesia, Obstetrical / Q000009:adverse effects; D004636:Emergency Service, Hospital; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D046648:Hematoma, Subdural, Intracranial / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D051299:Post-Dural Puncture Headache / Q000209:etiology*; D011247:Pregnancy; D012146:Rest
chemical_list: D005938:Glucocorticoids