Reactions 1406 - 16 Jun 2012

SBupivacaine

Intracranial subdural haematoma in an elderlypatient: case report

A 73-year-old woman developed an intracranial subduralhaematoma following spinal anaesthesia with bupivacaine.

The woman was admitted for arthroscopic knee surgery.She underwent spinal anaesthesia with a 2.3mL injection of0.5% bupivacaine between L4–5. Her surgery andpostoperative course were uneventful. However, onpostoperative day 5, she developed a headache withvomiting at 6:00am. Her headache persisted and sheappeared somnolent, while examination revealed a BP of232/103mm Hg. The woman received pentazocine. At9:00am, a CT scan revealed a subdural haematoma fromher left frontal to temporal region. She was treatedconservatively with BP control, rest and anantihaemorrhagic. After 7 days of rest, her headacheresolved. On day 12 after onset, a CT scan showedhaematoma absorption. One month later, a repeat CT scanrevealed further reduction in the haematoma volume. Onpostoperative day 49, she was without subjectivesymptoms, and was discharged.

Author comment: "We report a case of acute onset of anintracranial subdural hematoma without trauma five daysafter spinal anesthesia."Hagino T, et al. Acute onset of intracranial subdural hemorrhage five days afterspinal anesthesia for knee arthroscopic surgery: A case report. Journal of MedicalCase Reports 6: [3 pages], No. 75, 6 Mar 2012. Available from: URL: http://dx.doi.org/10.1186/1752-1947-6-75 - Japan 803071857

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Reactions 16 Jun 2012 No. 14060114-9954/10/1406-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved