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. 2016:2016:5789504.
doi: 10.1155/2016/5789504. Epub 2016 Aug 29.

Epidural Anesthesia Complicated by Subdural Hygromas and a Subdural Hematoma

Christine Vien  1 , Paul Marovic  2 , Brendan Ingram  1
Affiliations

Epidural Anesthesia Complicated by Subdural Hygromas and a Subdural Hematoma

Christine Vien et al. Case Rep Anesthesiol. 2016.

Abstract

Inadvertent dural puncture during epidural anesthesia leads to intracranial hypotension, which if left unnoticed can cause life-threatening subdural hematomas or cerebellar tonsillar herniation. The highly variable presentation of intracranial hypotension hinders timely diagnosis and treatment. We present the case of a young laboring adult female, who developed subdural hygromas and a subdural hematoma following unintentional dural puncture during initiation of epidural anesthesia.

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Figures

Figure 1
Figure 1
Nonintravenous contrast enhanced brain CT demonstrates bilateral CSF-density subdural hygromas (left subdural hygroma labelled with an open arrow) and a hyperdense acute right frontal subdural hematoma (solid arrow).
Figure 2
Figure 2
(a) Axial T2 weighted sequence demonstrates bilateral CSF-intensity subdural hygromas (arrows). (b) Coronal T1 weighted gadolinium enhanced sequence demonstrates pachymeningeal thickening and enhancement (arrows). (c) Sagittal T1 weighted sequence demonstrates pituitary gland enlargement. (d)–(f) Posttreatment MRI examination demonstrates complete radiological resolution.
See this image and copyright information in PMC

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