Intracranial Subdural Hygroma: A Rare Complication of Failed Neuraxial Anesthesia?

The unintentional puncture of the dura during epidural procedures is a noteworthy and prevalent complication in obstetric patients. Early recognition can be difficult, particularly when attempts at neuraxial anesthesia are unsuccessful. Rare intracranial complications, such as subdural hematomas and...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-04, Vol.15 (4), p.e37090
Main Authors: Lopes Simões Duarte, Duarte Filipe, Costa, Catarina, Gomes, Diana, Gomes, Nelson, da Fonte, Marcos Pacheco
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesiology
Asymptomatic
Blood
Brain
Caffeine
Case reports
Diplopia
Epidural
Headaches
Hematoma
Hemodynamics
Hydration
Hypotension
Medical imaging
Medical personnel
Neurology
Neurosurgery
Nonsteroidal anti-inflammatory drugs
Paresis
Patients
Strabismus
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Description
Summary:The unintentional puncture of the dura during epidural procedures is a noteworthy and prevalent complication in obstetric patients. Early recognition can be difficult, particularly when attempts at neuraxial anesthesia are unsuccessful. Rare intracranial complications, such as subdural hematomas and subdural hygromas, can occur after dural puncture and they should be suspected in the presence of atypical headaches or other neurological symptoms. We describe a case of a woman who had an unrecognized dural puncture following failed neuraxial anesthesia and later presented with symptoms of intracranial hypotension. Urgent investigation with cranial CT scan revealed two intracranial subdural hygromas. We discuss the diagnosis, follow-up, and successful management of this case with an epidural blood patch. It is crucial to maintain a high level of suspicion for complications after neuraxial anesthesia and to have a low threshold for imaging and investigation to prevent unfavorable or fatal consequences.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.37090