[Acute intracranial subdural hematoma after accidental dural puncture in epidural anesthesia]. / Hématome sous-dural aigu intracrânien après brèche dure-mérienne accidentelle lors d'une anesthésie péridurale.
Ann Fr Anesth Reanim
; 7(2): 156-8, 1988.
Article
en Fr
| MEDLINE
| ID: mdl-2452590
ABSTRACT
A case is reported of an acute intracranial subdural haematoma following an accidental dural puncture during an epidural anaesthesia. A seventy-year old man, class ASA I, was operated on for prostatic adenoma under epidural anaesthesia. Dural puncture occurred during the first introduction of the needle into the L4-L5 epidural space. Epidural anaesthesia was nevertheless obtained by introducing the catheter at the L3-L4 level. The immediate peroperative and postoperative course was uneventful, apart from persisting headache. After removing the epidural catheter at 24 h postoperatively, the patient received calcium heparinate. 26 h later, he complained of worsening headache and became rapidly deeply comatose. The computer tomographic scan showed air in the ventricles and a large right-sided subdural haematoma which was immediately discharged. Although the link between subdural haematoma and dural puncture is well known, the acuteness and rapidly fatal evolution of this case were exceptional and may have been facilitated by the big size of the needle, dehydration and hypercoagulability.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Heridas Penetrantes
/
Duramadre
/
Hematoma Subdural
/
Anestesia Epidural
Tipo de estudio:
Etiology_studies
Límite:
Aged
/
Humans
/
Male
Idioma:
Fr
Revista:
Ann Fr Anesth Reanim
Año:
1988
Tipo del documento:
Article