Intracranial bleed in the form of subdural hematoma (SDH) with intracranial hypotension after spinal anesthesia for cesarean section is a rare condition with an incidence of around 1 in 5,00,000 obstetric populations. As its presentation is similar to post-dural puncture headache (PDPH), it can be misdiagnosed sometimes. Persistent headache for more than 5 days, vomiting, blurring of vision, and convulsion can guide the diagnosis of intracranial bleed. Magnetic resonance imaging (MRI) helps to diagnose the location, size, and other abnormalities of bleed in such patients. The management ranges from conservative to surgical management in the form of craniotomy. Here, we present a case of a 19-year-old woman, who operated on for cesarean section under spinal anesthesia presented with SDH and intracranial hypotension on postoperative day (POD) 6. She was managed conservatively with plenty of intravenous (IV) fluids, bed rest, low head position, analgesics, and antiepileptics. A repeat computed tomography (CT) scan was performed after 14 days, which showed resolved SDH, and the patient was discharged.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10833041 | PMC |
| http://dx.doi.org/10.4103/sja.sja_356_23 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Azygos Vein Stenosis in Frontotemporal Dementia Sagging Brain Syndrome.
AJNR Am J Neuroradiol
January 2025
Ataxia Center, Cognitive Behavioral Neurology Unit, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Department of Neurology (J.D.S., Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Background And Purpose: Symptoms indistinguishable from behavioral-variant frontotemporal dementia (bvFTD) can develop in patients with spontaneous intracranial hypotension associated with severe brain sagging. An underlying spinal CSF leak can be identified in only a minority of these patients and the success rate of nondirected treatments, such as epidural blood patching and dural reduction surgery, is low. The disability associated with bvFTD sagging brain syndrome is high and, because of the importance of the venous system in the pathophysiology of CSF leaks in general, we have investigated the systemic venous circulation in those patients with recalcitrant symptoms.
View Article and Find Full Text PDFImpact of intravenous antihypertensive therapy on cerebral blood flow and neurocognition: a systematic review and meta-analysis.
Br J Anaesth
January 2025
Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, USA. Electronic address:
Background: Intravenous antihypertensivedrugs are commonly used in acute care settings, yet their impact on cerebral blood flow (CBF) remains uncertain.
Methods: A systematic review and meta-analysis of 50 studies evaluated the effects of commonly used i.v.
Miyazaki syndrome.
BMJ Case Rep
January 2025
Neurosurgery, Unidade Local de Saúde de Lisboa Ocidental, Lisboa, Portugal.
Miyazaki syndrome is a rare complication in patients with ventricular shunts, characterised by cervical myelopathy from cerebrospinal fluid overdrainage. Here we report a case of a young woman with a history of hydrocephalus who had a ventricular shunt placed in infancy, presenting to our department with signs and symptoms of myelopathy due to overshunting. This diagnosis is challenging because of the frequent absence of typical signs of intracranial hypotension, leading to delays in treatment, which carries the risk of potentially devastating consequences.
View Article and Find Full Text PDFPrevalence and characteristics of microspurs in patients with spontaneous intracranial hypotension compared to the general population.
AJNR Am J Neuroradiol
January 2025
From the Department of Neurosurgery (D.N., L.H., J.G., T.P., R.T.S., A.R., C.M.J.); Department of Neuroradiology (T.D., E.I.P.), Institute of Diagnostic and Interventional Neuroradiology, and Department of Neurology (C.S.), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Department of Neurosurgery (J.B.), Medical Center, University of Freiburg, Freiburg, Germany.
Background And Purpose: In patients diagnosed with spontaneous intracranial hypotension (SIH), microspurs are considered the culprit lesion in most ventral dural leaks (type I). The imaging characteristics of discogenic spurs, and their prevalence in the general population has not been reported in the literature.
Materials And Methods: This observational case-control study was conducted comparing the prevalence and characteristics of discogenic microspurs between SIH patients with a type I leak treated at a tertiary hospital between 2013 and 2023 and an age-and sex matched cohort of trauma patients.
Defining the typical characteristics of orthostatic headache in patients with spontaneous intracranial hypotension.
Cephalalgia
January 2025
Headache and Facial Pain Group, University College London (UCL) Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
Background: Orthostatic headache (OH) is a common feature of various conditions, including spontaneous intracranial hypotension (SIH), but no precise definition currently exists outlining the typical OH characteristics. This ambiguity risks misdiagnosis with unnecessary investigations and delay in institution of treatment. The present study aimed to carry out structured phenotyping of OH in patients with SIH with the aim of outlining its typical characteristics.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!