Intracranial Acute Subdural Hematoma after Spinal Anesthesia

Of 329 cases of nontraumatic ASDH, Elshanawany and Wahab identified 6 patients whose spontaneous ASDH developed following spinal anesthesia. All 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.

Although uncommon, intracranial ASDH should be considered in patients following spinal anesthesia, especially those with a prolonged headache after the procedure ¹⁾.

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