Abstract
Objective To describe our experience with the occurrence of intracranial acute subdural hematoma
(ASDH) following spinal anesthesia.
Patients and Methods We reviewed our records from 2010 to 2017 to detect cases of nontraumatic ASDH following
spinal anesthesia. All cases were analyzed for the etiological factors, time lag between
the procedure and hematoma diagnosis, treatment, and outcome.
Results Of 329 cases of nontraumatic ASDH, we identified 6 patients whose spontaneous ASDH
developed following spinal anesthesia. All our patients were obstetrical and received
spinal anesthesia for delivery. Patient ages ranged from 21 to 34 years. Two patients
presented with deterioration of consciousness a few hours after delivery. Three patients
presented with persistent headache and lethargy days after delivery. One patient presented
3 days after delivery with severe deterioration of consciousness. All patients had
undergone surgical evacuation of a hematoma. Five patients recovered and one patient
died 2 days after surgery. Records showed none of the six patients had coagulopathy
or any other blood disorder.
Conclusion Although uncommon, intracranial ASDH should be considered in patients following spinal
anesthesia, especially those with a prolonged headache after the procedure.
Keywords
acute subdural hematoma - spinal anesthesia - obstetric patients
