Subdural hematoma following dural puncture epidural anesthesia for labor analgesia: two case reports

Abstract Background Neuraxial anesthesia is widely used for labor analgesia in the USA, such as epidural, combined spinal–epidural, and dural puncture epidural (DPE). Post-dural headache (PDPH) a well-known complication of neuraxial anesthesia. However, rare yet more serious subdural hematomas. Untreated hematomas can result permanent disability death, hence need to better understand their development obstetric population receiving DPE. Case presentation one: A 34-year-old G6P3 female at 39-week gestation received DPE underwent cesarean section arrest descent. On postoperative day two, patient developed PDPH but opted conservative treatment. Ten days post-discharge, presented with large subacute chronic hematoma midline shift. The right fronto-temporal craniectomy, evacuation hematoma, placement drain. two: 31-year-old G1P0 41-week past medical history parietal hemangioma malaria 29-week induction labor. She subsequently primary failure progress persistent category-two fetal heart rate tracing. 11, she experienced severe non-positional right-sided headache. Imaging revealed overlying frontal temporal lobes, which was observed managed non-operatively. 14, an blood patch symptomatic intracranial hypotension. Conclusion PDPH, anesthesia, typically benign often self-resolves measures. avoid increased morbidity mortality, monitoring patients higher risk (especially those known preexisting pathologies) critical prompt diagnosis. As exemplified by our second case, patches continue be effective may considered