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Papers of the Week

2020 Jul

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Rare but Fatal Subdural Hematoma Following Spinal Anesthesia: A Case Report of Unrecognized Untreated Postdural Puncture Headache in a Low-Resource Country Setting.


Dural puncture following neuraxial anesthesia can cause persistent cerebrospinal fluid leakage. A 35-year-old, 39-week gestation healthy parturient underwent cesarean delivery under spinal anesthesia. Spinal anesthesia was performed using a 25-gauge Quincke needle. Despite the occurrence of postoperative positional headache and neck pain, she was discharged home. Two weeks following discharge, she developed seizures and deteriorating level of consciousness. Brain computerized tomography scan revealed massive left subdural hematoma. She died 3 days later. We discuss awareness of neuraxial complication among maternity staff, effective follow-up, and available management strategy in low-resource settings. Persistent headache following neuraxial anesthesia should be investigated.