A case of late diagnosis of chronic subdural hematoma following spinal anesthesia

Ali Aygun; Hava Semra Vuran; Nurhak Aksut; Yunus Karaca; Ozgur Tatli

doi:10.1016/j.tjem.2016.11.003

Ali Aygun¹, Hava Semra Vuran², Nurhak Aksut³, Yunus Karaca⁴, Ozgur Tatli⁴

¹Ordu University Training and Research Hospital, Department of Emergency Medicine, Ordu, Turkey
²Fatih State Hospital, Department of Emergency Medicine, Trabzon, Turkey
³Manisa State Hospital, Department of Emergency Medicine, Manisa, Turkey
⁴Karadeniz Technical University, Faculty of Medicine, Department of Emergency Medicine, Trabzon, Turkey

Abstract

Intracranial subdural hematoma developing following spinal anesthesia is a rare but serious complication. We describe a case of subdural hematoma developing following spinal anesthesia and diagnosed late.

A female patient receiving spinal anesthesia for cesarean delivery 45 days prior to arrival at the emergency department presented to our hospital with non-severe headache persisting for 45 days after discharge. Computerized tomography (CT) of the brain performed due to long-term persisting headache resistant to medical treatment and a history of spinal intervention revealed a hypodense chronic subdural hematoma in the left frontoparietal area and a shift from left to right in midline structures. The patient was operated and discharged without sequelae on the 7th day postoperatively.

Care must be taken over subdural hematoma in the presence of headache after spinal anesthesia persisting despite fluid intake and medical treatment and exceeding 48 h in duration, and diagnosis must not be delayed.