INTRODUCTION:
Spinal anesthesia is commonly used anesthesia during obstetric
procedures. Although complications related to spinal anesthesia are
generally benign, about 0.05% of complications are critical1,2. Post-dural puncture headache (PDPH ) and
hypotension are the most common complication of spinal anesthesia3.
Intracranial subdural hematoma (ISH) is one of the rare but fatal
complications of spinal anesthesia 1. ISH following
spinal anesthesia is reported to be more common in the obstetric
population. The incidence rate of ISH following neuraxial anesthesia in
the obstetric population is 0.0002% 2.
The most common presentation of intracranial subdural hematoma is
headache (74–91%) 2,4. When headache is the
presenting complaint in the puerperal period, ISH is rarely presumed,
leading to misdiagnosis and delay in treatment. Although an infrequent
complication, early diagnosis of this disease manifested by headache is
crucial during the post-partum period to avoid potentially fatal
complications that will impact both mother and the baby.
This study aims to report a rare case of chronic subdural hematoma
(CSDH) following lower segment cesarean section (LSCS) delivery after
spinal anesthesia and discuss the measures we can take for early
diagnosis and prevention of potentially fatal complications.