1/13. Chronic subdural haematoma following caesarean section under spinal anaesthesia.Intracranial subdural haematoma is a rare complication of spinal anaesthesia. This report describes the case of a 31-year-old woman who presented with post partum headache following spinal anaesthesia for caesarean section. Bilateral haematomata were evacuated via burr-holes performed under total intravenous anaesthesia and the patient made a complete and uneventful recovery. The recognized causes of subdural haematoma are discussed.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/13. Intracranial haemorrhage following lumbar myelography: case report and review of the literature.We describe a subacute intracranial subdural haematoma following lumbar myelography. This rare but potentially life-threatening complication has been reported both after lumbar myelography and following lumbar puncture for spinal anaesthesia. We review 16 previously reported cases of intracranial haemorrhage following lumbar myelography, and discuss the pathogenesis. In all reported cases post-puncture headache was the leading symptom and should therefore be regarded as a warning sign.- - - - - - - - - - ranking = 0.14285714285714keywords = anaesthesia (Clic here for more details about this article) |
3/13. Cranial subdural haematoma after spinal anaesthesia.Intracranial subdural haematoma is an exceptionally rare complication of spinal anaesthesia. A 20-yr-old male underwent appendicectomy under partial spinal and subsequent general anaesthesia. A week later, he presented with severe headache and vomiting not responding to bed rest and analgesia. magnetic resonance imaging showed a small acute subdural haematoma in the right temporo-occipital region. The patient improved without surgical decompression. The pathogenesis of headache and subdural haematoma formation after dural puncture is discussed and the literature briefly reviewed. Severe and prolonged post-dural puncture headache should be regarded as a warning sign of an intracranial complication.- - - - - - - - - - ranking = 0.85714285714286keywords = anaesthesia (Clic here for more details about this article) |
4/13. Acute-on-chronic subdural haematoma: a rare complication after spinal anaesthesia.An 88-year-old woman with an undiagnosed chronic subdural haematoma underwent emergency repair of a femoral hernia under spinal anaesthesia. The patient complained of headache postoperatively, and a subsequent computed tomography brain scan showed an acute-on-chronic subdural haematoma, with midline shift and impending coning. The patient recovered completely after surgical decompression. The difficulty in diagnosing chronic subdural haematoma in the elderly patient with no history of trauma is discussed, along with the differential diagnosis of headache following spinal anaesthetic in this age-group.- - - - - - - - - - ranking = 0.71428571428571keywords = anaesthesia (Clic here for more details about this article) |
5/13. Spinal subdural haematoma: how relevant is the INR?STUDY DESIGN: Case report. OBJECTIVE: To report a rare cause of spinal cord compression. SETTING: University Hospital, wales, UK. CASE REPORT: A 67-year-old gentleman on oral anticoagulation for atrial fibrillation presented with a 4-h history of progressive loss of sensation and weakness in both legs; there was no history of trauma. On examination, he had a flaccid paraplegia with altered sensation in the L1,2,3 dermatomes and complete anaesthesia in the L4,5 distribution. knee and ankle jerk reflexes were absent, plantars were equivocal and anal sphincter tone was reduced. The patient's international normalized ratio (INR) was 4.1. An MR scan showed an extensive intradural haematoma compressing the cauda equina. The anticoagulation was reversed and an urgent T12-L2 laminectomy was performed; findings were a circumferential haematoma at L1 extending in the anterior canal between T10 and L3. The patient had an uneventful postoperative course generally, but at 1 week there was no neurological recovery. CONCLUSION: This case highlights that anticoagulation even when well controlled is not without risk. This is particularly of concern as the number of patients receiving long-term anticoagulation therapy has doubled between 1993 and 1998.- - - - - - - - - - ranking = 0.14285714285714keywords = anaesthesia (Clic here for more details about this article) |
6/13. Acute subdural haematoma after accidental dural puncture during epidural anaesthesia.A case is reported of acute intracranial subdural haematoma following accidental dural puncture during epidural anaesthesia. A 36-year-old primigravida with a gestation of 37 weeks and 3 days underwent caesarean section for which epidural anaesthesia was initially planned. An 18-gauge Tuohy needle was inserted into the L3-4 interspace but accidental dural puncture occurred. The needle was removed and general anaesthesia was initiated for surgery. On the second day post partum, the patient described a headache in both occipital area and neck that was relieved by lying down. On the seventh post-partum day she suffered tonic-clonic convulsions and underwent computerised tomography (CT). Despite different analgesic treatments and a normal CT, the patient suffered severe headaches in the following days. magnetic resonance imaging revealed a 4-mm subdural hematoma in the right frontal area. The persisting headache decreased on day 12 and disappeared on day 14. The patient was discharged from hospital on day 15. The presence of post dural puncture headache complicated by atypical neurological deterioration following epidural anaesthesia should prompt the anaesthetist to consider the existence of intracranial complications and to seek immediate clinical and radiological diagnosis.- - - - - - - - - - ranking = 1.1428571428571keywords = anaesthesia (Clic here for more details about this article) |
7/13. Iatrogenic spinal subdural haematoma.Spinal subdural haematoma is a rare condition, usually seen in association with lumbar puncture or a bleeding disorder. It carries a high morbidity and mortality, and successful treatment requires prompt surgical intervention. We present a case of mixed spinal subarachnoid and subdural haemorrhage complicating failed spinal anaesthesia combined with anti-coagulation in an elderly woman, together with a review of the literature.- - - - - - - - - - ranking = 0.14285714285714keywords = anaesthesia (Clic here for more details about this article) |
8/13. Spontaneous spinal subdural haematoma during general anaesthesia.Spontaneous spinal subdural haematoma causing acute spinal cord compression is a well recognized condition and often responds well to early surgical intervention. In the elderly, the haematoma usually occurs as a result of minor trauma or atherosclerosis with hypertension. We present in this report the history of a patient who became paraplegic during a general anaesthetic for an operation for removal of a ureteral calculus. rupture of a spinal vascular malformation was found to be responsible for the subdural haematoma, which remained undiagnosed until surgical exploration.- - - - - - - - - - ranking = 0.57142857142857keywords = anaesthesia (Clic here for more details about this article) |
9/13. Subdural haematoma. A rare but life-threatening complication after spinal anaesthesia.A 70-year-old patient developed severe headache after spinal anaesthesia. He was treated with an epidural autologous blood patch with only temporary relief. Three weeks after the spinal anaesthesia, the headache became more intense and was accompanied by nausea and vomiting. A second epidural blood patch was performed without effect. The patient became unconscious and an acute CT scan revealed a large subdural haematoma. This was immediately evacuated and the patient made a good recovery. This case demonstrates that subdural haematoma should be considered as a possible aetiology in severe postspinal headache.- - - - - - - - - - ranking = 0.85714285714286keywords = anaesthesia (Clic here for more details about this article) |
10/13. Spinal subdural bleeding after attempted epidural and subsequent spinal anaesthesia in a patient on thromboprophylaxis with low molecular weight heparin.Despite the extensive use of low molecular weight heparins (LMWH) for thromboprophylaxis, only two serious complications have thus far been reported where spinal haematomas were incurred after epidural and spinal blocks in patients on such treatment. In our patient, who was on thromboprophylaxis with the LMWH drug enoxaparin, catheter epidural anaesthesia was abandoned due to a bloody tap and superseded by spinal anaesthesia. More than 40 hours later she had developed a paraparesis and complete sensory loss in the lower extremities. The MRT image showed haematomas epi- and subdurally, as well as subarachnoidally, but no epidural bleeding was seen at laminectomy.- - - - - - - - - - ranking = 0.85714285714286keywords = anaesthesia (Clic here for more details about this article) |
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