Intracranial subdural hematoma: a rare but serious complication following neuraxial anesthesia in obstetric anesthesia

Abstract

Intracranial subdural hematoma (SDH) formation is an uncommon but serious complication of planned or unintentional dural puncture (DP) during straight epidural anesthesia, combined spinal-epidural, dural puncture epidural, or spinal anesthesia. Diagnosis of intracranial SDH following neuraxial anesthesia may be delayed or misdiagnosed due to rare occurrence, lack of knowledge, as well as an overlap in clinical presentation with postdural puncture headache (PDPH). Increased awareness of intracranial SDH as a complication of DP may result in earlier recognition and prevention of potentially devastating outcomes. This article reviews the relevant literature on association of neuraxial anesthesia with intracranial SDH formation. Key words: Intracranial subdural hematoma; Anesthesia, Neuraxial; Anesthesia, Epidural; Combined spinal-epidural; Dural puncture; Anesthesia, spinal; Pregnancy; Postdural puncture headache Citation: Dhoon TQ, Joshi J, Portnoy D, Rajan GC. Intracranial subdural hematoma: a rare but serious complication following neuraxial anesthesia in obstetric anesthesia. Anaesth. pain intensive care 2021;25(6):828-831: DOI: 10.35975/apic.v25i6.1719 Received: August 4, 2021, Reviewed: September 2, 2021, Accepted: October 3, 2021