Postdural puncture subdural hematoma or postdural puncture headache?: two cases report.
Spinal anesthesia is widely used for many obstetric, gynecological, orthopedic, and urological operations. Subdural hematomas may occur after trauma and are associated with high morbidity and mortality rates. Postdural puncture headache (PDPH) is a benign condition and the most frequent complication of spinal anesthesia. The high rate of headache after spinal anesthesia may mask or delay the diagnosis of subdural hematoma. The true incidence of postdural puncture subdural hematoma (PDPSH) is unknown because most affected patients are probably managed without investigation. Therefore, the true incidence of PDPSH may be greater than suggested by previous reports. The differentiation of headache associated with subdural hematoma from PDPH is crucial. We herein report two cases of bilateral subdural hematoma after epidural anesthesia and emphasize the importance of suspicion for PDPSH and careful evaluation of patients with headache after spinal anesthesia.
Department of Neurosurgery, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey.
Aydemir
A
Kale
Department of Neurosurgery, Gazi University Faculty of Medicine, Ankara, Turkey.
Hakan
H
Emmez
Department of Anesthesiology, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey.
Özcan
Ö
Pişkin
Department of Neurosurgery, Gazi University Faculty of Medicine, Ankara, Turkey.
Emre
E
Durdağ
Postdural puncture headache; Spinal anesthesia; Subdural hematoma