Subdural hygroma accompanied by parenchymal and subarachnoid haemorrhage after epidural analgesia in an obstetric patient
Corresponding Author
M. DEL-RIO-VELLOSILLO
Department of Anesthesia, University Hospital Virgen de la Arrixaca, Murcia, Spain
Address:
Dr Monica del-Rio-Vellosillo
Department of Anaesthesia
University Hospital Virgen de la Arrixaca
Ctra. Madrid-Cartagena, s/n
30120 El Palmar, Murcia
Spain
e-mail: [email protected]
Search for more papers by this authorJ. J. GARCIA-MEDINA
Department of Ophthalmology and Optometry, School of Medicine, University of Murcia, Murcia, Spain
Department of Ophthalmology, General University Hospital Reina Sofia, Murcia, Spain
Search for more papers by this authorL. E. FERNANDEZ-RODRIGUEZ
Department of Anesthesia, University Hospital Virgen de la Arrixaca, Murcia, Spain
Search for more papers by this authorR. MARTIN-GIL-PARRA
Department of Anesthesia, University Hospital Virgen de la Arrixaca, Murcia, Spain
Search for more papers by this authorJ. LOPEZ-PEREZ
Department of Anesthesia, University Hospital Virgen de la Arrixaca, Murcia, Spain
Search for more papers by this authorM. J. ALMAGRO-NAVARRO
Department of Neurosurgery, University Hospital Virgen de la Arrixaca, Murcia, Spain
Search for more papers by this authorCorresponding Author
M. DEL-RIO-VELLOSILLO
Department of Anesthesia, University Hospital Virgen de la Arrixaca, Murcia, Spain
Address:
Dr Monica del-Rio-Vellosillo
Department of Anaesthesia
University Hospital Virgen de la Arrixaca
Ctra. Madrid-Cartagena, s/n
30120 El Palmar, Murcia
Spain
e-mail: [email protected]
Search for more papers by this authorJ. J. GARCIA-MEDINA
Department of Ophthalmology and Optometry, School of Medicine, University of Murcia, Murcia, Spain
Department of Ophthalmology, General University Hospital Reina Sofia, Murcia, Spain
Search for more papers by this authorL. E. FERNANDEZ-RODRIGUEZ
Department of Anesthesia, University Hospital Virgen de la Arrixaca, Murcia, Spain
Search for more papers by this authorR. MARTIN-GIL-PARRA
Department of Anesthesia, University Hospital Virgen de la Arrixaca, Murcia, Spain
Search for more papers by this authorJ. LOPEZ-PEREZ
Department of Anesthesia, University Hospital Virgen de la Arrixaca, Murcia, Spain
Search for more papers by this authorM. J. ALMAGRO-NAVARRO
Department of Neurosurgery, University Hospital Virgen de la Arrixaca, Murcia, Spain
Search for more papers by this authorAbstract
Background
Anaesthetists need to know the different causes of persistent headache or a change in level of consciousness following epidural analgesia for labour. Failure to recognise these neurological complications can lead to delayed diagnoses, with subsequent serious implications.
Methods
We present a patient who was re-admitted for postural headache resulting from an unrecognised dural puncture during an epidural for pain relief while in labour. During the interview, the patient confirmed drug use (cocaine), so she was evaluated by a psychiatrist with possible post-partum psychosis or drug withdrawal syndrome. Afterwards, the patient deteriorated neurologically, showing impaired consciousness and seizures.
Results
The cranial computed tomography showed bilateral frontoparietal subdural collections with intraparenchymal and subarachnoid haemorrhaging. She improved by burr hole drainage of subdural hygroma and a blood patch.
Conclusions
Neurological signs should alert the clinician to the possibility of subdural collection and other possible complications such as sinking of the brain in order not to delay the request for imaging tests for diagnoses and effective treatments.
References
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