Intracranial Subdural Hematoma after Spinal Anesthesia: Report of Two Cases with different Outcomes

Abstract

Spinal anesthesia is a technique commonly used for local anesthesia and in obstetric surgeries. Rarely, the formation of an intracranial subdural hematoma (SDH) may result from spinal anesthesia, constituting a serious condition that often leads to severe neurological deficits. The presentation and course of this pathology may occur in a completely different way, which makes its diagnosis and management difficult. In the present article, the authors report two cases of patients with intracranial SDH after spinal anesthesia with completely different presentations and outcomes, demonstrating the variability of the manifestations of this condition. A quick review of key points of its pathophysiology, symptomatology, diagnosis, and treatment was also performed.

Resumo

Raquianestesia é uma técnica comumente utilizada para procedimentos locais e cirurgias obstétricas. Raramente, a formação de um hematoma subdural intracraniano pode ser resultado de uma raquianestesia, constituindo uma condição grave que frequentemente leva a déficits neurológicos severos. A apresentação e o curso desta patologia podem ocorrer de formas completamente distintas, fato que dificulta seu diagnóstico e manejo. No presente artigo, os autores relatam dois casos de pacientes que desenvolveram um hematoma subdural intracraniano após raquianestesia com apresentações e desfechos completamente diferentes, demonstrando a variabilidade das manifestações desta condição. Uma rápida revisão dos pontos-chave da fisiopatologia, da sintomatologia, do diagnóstico e do tratamento também foi realizada.

Keywords

subdural hematoma - spinal anesthesia - intracranial bleeding - anesthesia complication.

Palavras-chave

hematoma subdural - raquianestesia - hemorragia intracraniana - complicação anestésica

• References

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