Epidural analgesia failure followed by intracranial subdural hematoma: a case report

VernacularTitle:硬膜外镇痛失败产后并发颅内硬膜下血肿1例
Author: Yong ZENG ¹ ; Xiaowen WANG ; Xufeng ZHANG ; Wen WANG ; Wenrong HE
Author Information

1. 长江大学附属第一医院　湖北省荆州市第一人民医院产科，荆州　434000
Keywords: Analgesia, epidural; Analgesia, obstetrical; Hematoma, subdural, intracranial
From: Chinese Journal of Perinatal Medicine 2022;25(7):550-552
CountryChina
Language:Chinese
Abstract: We report the diagnosis and treatment of a rare case of epidural analgesia failure followed by postpartum subdural hematoma. The patient underwent vaginal delivery under epidural analgesia at 32 +6 gestational weeks due to threatened premature labor, during which an unexpected dural rupture occurred. She gave no history of headache and there was no obvious abnormality during the pregnancy. However, on postpartum day 4, the patient complained of headache that could not be relieved when supine, but without any other neurological symptoms. A prompt cranial CT examination showed a left frontotemporal subdural hematoma. After conservative management with intravenous drip of mannitol, re-examination of cranial CT showed that the left frontotemporal subdural hematoma was mostly absorbed and the patient was discharged on postpartum day 18. The patient was healthy during follow up. Intracranial subdural hematoma after dural puncture is a rare and serious complication that requires early recognition and treatment.