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Brazilian Journal of Anesthesiology
Article . 2015 . Peer-reviewed
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Brazilian Journal of Anesthesiology
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Bilateral subdural hematoma secondary to accidental dural puncture

Authors: Ramírez, Sofía; Gredilla, Elena; Martínez, Blanca; Gilsanz, Fernando;

Bilateral subdural hematoma secondary to accidental dural puncture

Abstract

We report the case of a 25-year-old woman, who received epidural analgesia for labor pain and subsequently presented post-dural puncture headache. Conservative treatment was applied and epidural blood patch was performed. In the absence of clinical improvement and due to changes in the postural component of the headache, a brain imaging test was performed showing a bilateral subdural hematoma. The post-dural puncture headache is relatively common, but the lack of response to established medical treatment as well as the change in its characteristics and the presence of neurological deficit, should raise the suspicion of a subdural hematoma, which although is rare, can be lethal if not diagnosed and treated at the right time.

Related Organizations
Keywords

Placa de sangue epidural, Adult, Parche hemático epidural, Epidural analgesia, Neuroimaging, Post-dural puncture headache, Dura-máter, Subdural hematoma, Hematoma subdural, Anesthesiology, Pregnancy, Punción dural accidental, Humans, RD78.3-87.3, Analgesia epidural, Labor Pain, Epidural blood patch, Cefaleia pós-punção dural, Accidental dural puncture, Analgesia, Epidural, Cefalea pospunción dural, Hematoma, Subdural, Analgesia, Obstetrical, Female, Post-Dural Puncture Headache, Dura-Máter, Blood Patch, Epidural

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    selected citations
    These citations are derived from selected sources.
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    8
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Average
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
8
Top 10%
Average
Average
Green
gold