Intracranial Acute Subdural Hematoma Following Spinal Anesthesia: Our Experience with Six Patients

Objective To describe our experience with the occurrence of intracranial acute subdural hematoma (ASDH) following spinal anesthesia. Patients and Methods We reviewed our records from 2010 to 2017 to detect cases of nontraumatic ASDH following spinal anesthesia. All cases were analyzed for the etiological factors, time lag between the procedure and hematoma diagnosis, treatment, and outcome. Results Of 329 cases of nontraumatic ASDH, we identified 6 patients whose spontaneous ASDH developed following spinal anesthesia. All our patients were obstetrical and received spinal anesthesia for delivery. Patient ages ranged from 21 to 34 years. Two patients presented with deterioration of consciousness a few hours after delivery. Three patients presented with persistent headache and lethargy days after delivery. One patient presented 3 days after delivery with severe deterioration of consciousness. All patients had undergone surgical evacuation of a hematoma. Five patients recovered and one patient died 2 days after surgery. Records showed none of the six patients had coagulopathy or any other blood disorder. Conclusion Although uncommon, intracranial ASDH should be considered in patients following spinal anesthesia, especially those with a prolonged headache after the procedure.