CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2019; 38(03): 215-218
DOI: 10.1055/s-0039-1692123
Case Report | Relato de Caso
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

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

Hematoma subdural intracraniano após raquianestesia: relato de dois casos com diferentes desfechos
Guilherme Gago
2   Department of Neurosurgery, Hospital São José, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
,
1   Department of Specialized Medicine, Universidade Federal de Pelotas, Pelotas, RS, Brazil
,
Pedro Luís Gobatto
2   Department of Neurosurgery, Hospital São José, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
,
Fernando Antônio de Oliveira Costa
3   Department of Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
,
Ricardo Santin
2   Department of Neurosurgery, Hospital São José, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
,
Matheus Prado Magalhães
2   Department of Neurosurgery, Hospital São José, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
,
Antônio Delacy Martini Vial
2   Department of Neurosurgery, Hospital São José, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
› Author Affiliations
Further Information

Publication History

18 March 2019

17 April 2019

Publication Date:
31 May 2019 (online)

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.

 
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