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British Journal of Anaesthesia, 2001, Vol. 86, No. 5 720-723
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Subdural haematoma after dural puncture headache treated by epidural blood patch

J. M. Davies*,1, A. Murphy2, M. Smith2 and G. O’Sullivan1

1Department of Anaesthetics, St Thomas’ Hospital, Lambeth Palace Rd, London SE1 7EH, UK. 2Department of Anaesthetics, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK*Corresponding author

Subdural haematoma is a well-documented complication of accidental dural puncture, and is thought to be preventable by prompt treatment with an epidural blood patch. An accidental dural puncture occurred in a 39-yr-old primagravida during the siting of an epidural catheter for pain relief in labour. Twenty hours after the puncture, the mother developed a typical post-dural puncture headache, which increased in severity over the subsequent 24 h. An epidural blood patch was performed at 48 h, and this initially relieved the headache. After discharge from hospital, and 14 days after the dural puncture, the headache recurred, together with expressive dysphasia, poor co-ordination and sensory loss in the right arm. A magnetic resonance imaging scan demonstrated a left sided subdural haematoma, which was drained successfully with complete recovery.

Br J Anaesth 2001; 86: 720–3


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