P.132 Subdural haematoma formation: a rare complication of dural puncture during epidural insertion

AbstractObjective:To report a case of subdural haematoma occurring as an extremely rare and life-threatening complication of cochlear implantation, and to explore the causative association between intracranial haemorrhage and cochlear implantation surgical techniques. This association has not previously been reviewed in depth.Case report:A three-year-old boy was diagnosed with a large subdural haematoma, one week after cochlear implantation. After emergency evacuation of the haematoma, the patient made an excellent recovery and was discharged from hospital without any neurological deficit.Results:Mechanisms of injury are discussed and the literature reviewed, focusing on the possible causes of intracranial haemorrhage identified after cochlear implantation. Notably, bone drilling had been used in all reported cases, and the probable causative injury had always occurred after such drilling.Conclusion:The issue of bone drilling during cochlear implantation is raised, and alternative methods of implant housing suggested, in order to avoid intracranial haemorrhage.

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Cranial subdural haematoma after spinal anaesthesia: perhaps not so rare complication

European Journal of Anaesthesiology ◽

10.1097/eja.0b013e32833455ad ◽

2010 ◽

Vol 27 (3) ◽

pp. 307-308

Author(s):

Carlos L Errando ◽

Paula Perez-Caballero

Keyword(s):

Spinal Anaesthesia ◽

Subdural Haematoma ◽

Rare Complication

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Subdural Hematoma Following Spinal Cord Stimulator Implant

January 2018 - Pain Physician ◽

10.36076/ppj.2008/11/97 ◽

2008 ◽

Vol 1;11 (1;1) ◽

pp. 97-101

Author(s):

Srinivas Chiravuri

Keyword(s):

Spinal Cord ◽

Subdural Hematoma ◽

Dural Puncture ◽

Rare Complication ◽

Delayed Diagnosis ◽

Secondary Process ◽

Spinal Cord Stimulator ◽

Diagnostic Challenge ◽

Treatment Change ◽

Presenting Symptoms

Headache following interventional procedures is a diagnostic challenge due to the multitude of possible etiologies involved. Presentation can be simple (PDPH alone) or complex (exacerbation of pre-existing chronic headache along with PDPH) or headache associated with a new onset intracranial process. Subdural hematoma is a rare complication of cranio-spinal trauma. Cranial subdural hematoma may present in an acute, sub-acute, or chronic fashion. Diagnosis of a subdural hematoma in the wake of a PDPH is difficult, requiring a high level of suspicion. Delayed diagnosis of subdural hematoma is usually related to failure to consider it in the differential diagnosis. Thorough history, assessment of the evolution of symptoms, and imaging studies may identify the possible cause and help direct treatment. Change in the character of initial presenting symptoms may be a sign of resolution of the headache or the onset of a secondary process. We report a case of acute intracranial subdural hematoma secondary to unintentional dural puncture during placement of a permanent spinal cord stimulator lead for refractory angina. There is need for careful follow-up of patients with a known post-dural tear. Failure to identify uncommon adverse events in patients with complicated spinal cord stimulator implantation may lead to permanent injury. Key words: Subdural, post-dural puncture, headache, spinal cord stimulation

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