Subdural Hematoma following Accidental Dural Puncture while Performing Epidural Analgesia - A Case Report

ABSTRACT

Introduction: Subdural hematoma is a rare but seriouscomplication of accidental dural puncture during epidural orspinal anesthesia. This case report emphasizes the importanceof close follow-up of patients with post dural punctureheadache following accidental dural puncture and methods toidentify development of subdural hematoma in such patients.Case report a 23-year-old healthy primigravida developedaccidental dural puncture while trying to locate epiduralspace using a Tuohy needle for painless labor. The patientcomplained of headache on the 2nd post-operative day that wassignificantly relieved by analgesics, bed rest and hydration.Later she presented with severe headache that becamepersistent and lost its correlation with change of posture.Other than feeling nauseated she had no other additional signsand symptoms. Diagnosis of the SDH was confirmed via CTand treated surgically. The patient recovered completely.Conclusion: One should consider the possibility of subduralhematoma in patients when postdural puncture headache isprolonged or has a change in the character of headache withor without neurological symptoms for an early successfulintervention.