Intracranial subdural hematoma after spinal anesthesia for cesarean section: A case report
DOI:
https://doi.org/10.59692/jogeca.v33i4.457Keywords:
intracranial subdural hematoma, spinal anesthesia, surgical management, craniotomyAbstract
Background: Intracranial subdural hematoma (ISH) is a known but rare complication of spinal anesthesia that mainly presents with persistent headaches.
Case presentation: A 35-year-old gravida 2 para 2 presented to the outpatient clinic with a history of headaches, dizziness, and vomiting for two days after an elective cesarean section under spinal anesthesia 20 days prior. Brain magnetic resonance imaging (MRI) revealed bilateral subdural hematomas. She was scheduled for burr hole craniotomy and was discharged five days post-evacuation. She presented seven days later with a two-day history of convulsions and headaches. A computed tomography scan revealed recurrent bilateral subdural hematomas that were evacuated via repeat burr hole craniotomy. Postoperatively, she developed blurred vision, diplopia, slurred speech, and episodes of loss of balance. A repeat MRI showed satisfactory clearance of the hematomas before discharge.
Conclusion: A high index of suspicion for ISH should be indicated in patients with severe and persistent headaches after spinal anesthesia not relieved by conservative treatment, especially with the onset of other neurological symptoms.
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