Intracranial subdural hematoma after spinal anesthesia for cesarean section: A case report

Authors

  • Dr. Kelvin Mutwiri Department of Reproductive Health, Moi University, Eldoret, Kenya.
  • Dr. Tapson Mulunda Department of Obstetrics and Gynecology, Aga Khan Hospital, Kisumu, Kenya.

DOI:

https://doi.org/10.59692/jogeca.v33i4.457

Keywords:

intracranial subdural hematoma, spinal anesthesia, surgical management, craniotomy

Abstract

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.

Author Biographies

Dr. Kelvin Mutwiri, Department of Reproductive Health, Moi University, Eldoret, Kenya.

Department of Reproductive Health, Moi University, Eldoret, Kenya.

Dr. Tapson Mulunda, Department of Obstetrics and Gynecology, Aga Khan Hospital, Kisumu, Kenya.

Department of Obstetrics and Gynecology, Aga Khan Hospital, Kisumu, Kenya.

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Published

2021-09-30

How to Cite

Mutwiri, K. ., & Mulunda, T. . (2021). Intracranial subdural hematoma after spinal anesthesia for cesarean section: A case report. Journal of Obstetrics and Gynaecology of Eastern and Central Africa, 33(4), 127–129. https://doi.org/10.59692/jogeca.v33i4.457