Journal of Korean Neurosurgical Society

  • 제40권5호
  • /
  • Pages.384-386
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  • 2006
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
권호 표지

Acute Subdural Hematoma after Accidental Dural Puncture During Epidural Anesthesia

  • Kim, Il-Sup (Department of Neurosurgery, St. Vincent Hospital, The Catholic University of Korea) ;
  • Lee, Sang-Won (Department of Neurosurgery, St. Vincent Hospital, The Catholic University of Korea) ;
  • Son, Byung-Chul (Department of Neurosurgery, St. Vincent Hospital, The Catholic University of Korea) ;
  • Hong, Jae-Taek (Department of Neurosurgery, St. Vincent Hospital, The Catholic University of Korea)
  • 발행 : 2006.11.30
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초록

Acute subdural hematoma is an exceptionally rare, but life-threatening complication of spinal anesthesia. The authors report here on a case of acute subdural hematoma in a 52-year-old male who underwent an arthroscopic knee joint operation under spinal epidural anesthesia due to tearing of the medial meniscus. He complained of headache after surgery. Computed tomography[CT] revealed acute subdural hematoma in the right fronto-tempo-parietal area. The headache progressed in spite of analgesics and bed rest; two weeks later, the CT showed subacute subdural hematoma with a mass effect. The patient improved after surgical decompression. The pathogenesis of subdural hematoma formation after dural puncture is discussed and we briefly review the relevant literature. Prolonged and severe postdural puncture headache[PDPH] should be viewed with suspicion and investigated promptly to rule out any intracranial complications. Immediate treatment of the PDPH with an epidural blood patch to prevent further CSF leakage should be considered.

키워드

참고문헌

  1. Baldwin L, Galizia E : Bilateral subdural haematomas : a rare diagnostic dilemma following spinal anaesthesia. Anaesth Intensive Care 21 : 120-121, 1993
  2. Bjarnhall M, Ekseth K, Bostrom S, Vegfors M : Intracranial subdural haematoma-a rare complication following spinal anaesthesia. Acta Anaesthesiol Scand 40 : 1249-1251, 1996 https://doi.org/10.1111/j.1399-6576.1996.tb05559.x
  3. Blake DW, Donnan G, Jensen D : Intracranial subdural haematoma after spinal anaesthesia. Anaesth Intensive Care 15 : 341-342, 1987
  4. Cantais E, Behnamou D, Petit D, Palmier B : Acute subdural hematoma following spinal anesthesia with a very small spinal needle. Anesthesiology 93 : 1354-1356, 2000 https://doi.org/10.1097/00000542-200011000-00033
  5. De Tommaso O, Caporuscio A, Tagariello V : Neurological complications following central neuraxial blocks: are there predictive factors? Eur J Anaesthesiol 19 : 705-716, 2002 https://doi.org/10.1017/S0265021502001163
  6. Gass H, Goldstein AS, Ruskin R, Leopold NA : Chronic postmyelogram headache. Isotopic demonstration of dural leak and surgical cure. Arch Neurol 25 : 168-170, 1971 https://doi.org/10.1001/archneur.1971.00490020086010
  7. Gaucher DJ Jr, Perez JA Jr : Subdural hematoma following lumbar puncture. Arch Int Med 162 : 1904-1905, 2002 https://doi.org/10.1001/archinte.162.16.1904
  8. Kelsaka E, Sarihasan B, Baris S, Tur A : Subdural hematoma as a late complication of spinal anesthesia. J Neurosurg Anesthesiol 15 : 47-49, 2003 https://doi.org/10.1097/00008506-200301000-00008
  9. Newrick P, Read D : Subdural haematoma as a complication of spinal anaesthetic. Br Med J 285 : 341-342, 1982
  10. Scott DB, Hilbbard BM : Serious non-fatal complications associated with extradural block in obstetric practice. Br J Anaesth 64 : 170-192, 1990 https://doi.org/10.1093/bja/64.2.170
  11. Stocks GM, Woller DJA, Young JM, Fernando R : Postpartum headache after epidural blood patch : investigation and diagnosis. Br J Anaesth 84 : 407-410, 2000 https://doi.org/10.1093/oxfordjournals.bja.a013451
  12. Suess O, Stendel R, Baur S, Schilling A, Brock M : Intracranial haemorrhage following lumbar myelography : case report and review of the literature. Neuroradiology 42 : 211-214, 2000 https://doi.org/10.1007/s002340050049
  13. Tryba M : Epidural regional anesthesia and low molecular heparin : Pro. Anasthesiol Intensivmed Notfallmed Schmerzther 28 : 179-181, 1993 https://doi.org/10.1055/s-2007-998902
  14. Vaughan DJA, Stirrup CA, Robinson PN : Cranial subdural haematoma associated with dural puncture in labour. Br J Anaesth 84 : 518-520, 2000 https://doi.org/10.1093/oxfordjournals.bja.a013483
  15. Wells JB, Sampson IH : Subarachnoid hemorrhage presenting as postdural puncture headache : a case report. Mt Sinai J Med 69 : 109-110, 2002