Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Jul-Sep;13(3):931-934.
doi: 10.4103/ajns.AJNS_115_18.

Subdural Hematoma as a Consequence of Labor Epidural Analgesia

Luca De Lipsis  1 , Rossella Belmonte  1 , Maria Cusano  1 , Maria Antonietta Giannetti  1 , Carmine Franco Muccio  2 , Mauro Mancinelli  3
Affiliations
Case Reports

Subdural Hematoma as a Consequence of Labor Epidural Analgesia

Luca De Lipsis et al. Asian J Neurosurg. 2018 Jul-Sep.

Abstract

Subdural hematoma (SDH) following labor epidural analgesia is a rare neurological complication. SDH is a late complication of this procedure; it is caused by a leak of cerebrospinal fluid that may damage the vascular structures of the brain. Persistent headache in the days after labor epidural analgesia is a nonspecific clinical symptom caused by hematoma. Preexisting vascular malformations can be a concomitant cause of headache. Clinical cases have been reported even after epidural anesthesia. The differential diagnosis includes unspecified headache, sinusitis headache, drug-induced headache, cortical vein thrombosis, fistula of the dura mater, and bacterial, viral, and aseptic meningitis.

Keywords: Accidental dural puncture; blood patch; dural fistula; epidural analgesia; subdural hematoma.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Bilateral subdural hematoma, clearly visible on the left. Sequences, from left to right: Cor T2, Ax fluid-attenuated inversion recovery, and Ax T1
Figure 2
Figure 2
Dural fistula with fluid collection in soft tissues near spinal epidural access. Sag STIR sequence
Figure 3
Figure 3
Follow-up examination shows reduced right subdural hematoma and increased left subdural hematoma. Sequences, from left to right: Cor T2, Ax fluid-attenuated inversion recovery, and Ax T1
Figure 4
Figure 4
Follow-up examination shows no dural fistula and no fluid collection. Sequence Sag T2 FAT SAT
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Bilić N, Djaković I, Kličan-Jaić K, Rudman SS, Ivanec Ž. Epidural analgesia in labor-controversies. Acta Clin Croat. 2015;54:330–6. - PubMed
    1. Moschini V, Marra G, Dabrowska D. Complications of epidural and combined spinal-epidural analgesia in labour. Minerva Anestesiol. 2006;72:47–58. - PubMed
    1. Bisinotto FM, Dezena RA, Fabri DC, Abud TM, Canno LH. Intracranial subdural hematoma: A rare complication following spinal anesthesia: Case report. Rev Bras Anestesiol. 2012;62:88–95. - PubMed
    1. Nolte CH, Lehmann TN. Postpartum headache resulting from bilateral chronic subdural hematoma after dural puncture. Am J Emerg Med. 2004;22:241–2. - PubMed
    1. Arevalo-Rodriguez I, Ciapponi A, Roqué i Figuls M, Muñoz L, Bonfill Cosp X. Posture and fluids for preventing post-dural puncture headache. Cochrane Database Syst Rev. 2016;3:CD009199. - PMC - PubMed

Publication types