FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2105485865> ?p ?o ?g. }

• W2105485865 endingPage "895" @default.
• W2105485865 startingPage "893" @default.
• W2105485865 abstract "Intracranial subdural haematoma is an exceptionally rare complication of spinal anaesthesia. A 20-yr-old male underwent appendicectomy under partial spinal and subsequent general anaesthesia. A week later, he presented with severe headache and vomiting not responding to bed rest and analgesia. Magnetic resonance imaging showed a small acute subdural haematoma in the right temporo-occipital region. The patient improved without surgical decompression. The pathogenesis of headache and subdural haematoma formation after dural puncture is discussed and the literature briefly reviewed. Severe and prolonged post-dural puncture headache should be regarded as a warning sign of an intracranial complication. Intracranial subdural haematoma is an exceptionally rare complication of spinal anaesthesia. A 20-yr-old male underwent appendicectomy under partial spinal and subsequent general anaesthesia. A week later, he presented with severe headache and vomiting not responding to bed rest and analgesia. Magnetic resonance imaging showed a small acute subdural haematoma in the right temporo-occipital region. The patient improved without surgical decompression. The pathogenesis of headache and subdural haematoma formation after dural puncture is discussed and the literature briefly reviewed. Severe and prolonged post-dural puncture headache should be regarded as a warning sign of an intracranial complication. The most common complication of spinal anaesthesia is headache. Post-dural puncture headache (PDPH) is classically postural and responds within 48 h to increased fluid intake and bed rest. Prolonged PDPH may be caused by subdural haematoma1Pavlin DJ McDonald JS Child B et al.Acute subdural hematoma—an unusual sequela to lumbar puncture.Anesthesiology. 1979; 51: 338-340Crossref PubMed Scopus (66) Google Scholar, 2Vaughan DJA Stirrup CA Robinson PN Cranial subdural haematoma associated with dural puncture in labour.Br J Anaesth. 2000; 84: 518-520Abstract Full Text PDF PubMed Scopus (53) Google Scholar, 3Rudehill A Gordon E Rahn T Subdural haematoma: a rare but life-threatening complication after spinal anaesthesia.Acta Anaesthesiol Scand. 1983; 27: 376-377Crossref PubMed Scopus (27) Google Scholar, 4Velarde CA Zuniga RE Leon RF et al.Cranial nerve palsy and intracranial subdural hematoma following implantation of intrathecal drug delivery device.Regional Anaesth Pain Med. 2000; 25: 76-78Crossref PubMed Scopus (32) Google Scholar or intracerebral haemorrhage.5Mantia AM Clinical report of the occurrence of an intracerebral hemorrhage following post-lumbar puncture headache.Anesthesiology. 1981; 55: 684-685Crossref PubMed Scopus (54) Google Scholar Few anecdotal cases of this neurological complication are described in the literature. We report a case of cranial subdural haematoma in a patient who underwent spinal anaesthesia for appendicectomy. A 20-yr-old male was admitted with abdominal pain and vomiting. Acute appendicitis was diagnosed and appendicectomy was performed under spinal anaesthesia. A 23G Quincke point spinal needle was introduced through the L4–5 interspace. After dural puncture at the first attempt, 1.8 ml of 0.5% heavy bupivacaine was injected. This was only partially effective, so general anaesthesia was induced with thiopentone 200 mg, succinylcholine 80 mg and atropine 0.6 mg. Anaesthesia was maintained with 0.5% halothane, pentazocine 30 mg and midazolam 1 mg. Muscle relaxation was maintained by a further dose of succinylcholine 80 mg given 20 min later. The patient remained haemodynamically stable. The excised appendix was grossly inflamed; histopathology confirmed the diagnosis of acute appendicitis. The patient recovered fully and was discharged on the third day after the operation. He had no headache at the time of discharge. However, a week later, he developed a severe diffuse headache which did not subside with analgesia and bed rest. When he started to vomit, an intracranial lesion was suspected and a neurosurgical consultation was sought. There was no history of fever, trauma or bleeding diathesis. On examination, the patient was conscious and oriented: Glasgow coma score was 15, fundi were normal and there was no focal neurological deficit. He had no neck rigidity or Kernig’s sign. Haemoglobin, total and differential leucocyte counts, platelet count, bleeding time, clotting time, prothrombin time and activated partial thromboplastin time (APTT) were normal. Biochemical values, including liver and renal function tests, were also normal. Magnetic resonance imaging of the head showed a small acute subdural haematoma in the right temporo-occipital region with no mass effect. The patient was managed conservatively with bed rest, analgesia and intravenous fluids. He recovered completely and was discharged after a week. Headache is the most frequent complication after lumbar puncture, occurring in ≤40% of cases.6Alemohammad S Bouzarth WF Intracranial subdural hematoma following lumbar myelography.J Neurosurg. 1980; 52: 256-258Crossref PubMed Scopus (21) Google Scholar Such headaches are thought to be caused by excessive (≤250 ml day–1)7Frankson C Gordth T Headache after spinal anaesthesia and a technique for lessening its frequency.Acta Chir Scand. 1964; 94: 413Google Scholar leakage of cerebrospinal fluid (CSF) through the dural puncture, causing caudal displacement of intracranial structures.8Gass H Goldstein AS Ruskin R et al.Chronic post-myelogram headache. Isotopic demonstration of dural leak and surgical cure.Arch Neurol. 1971; 25: 168-170Crossref PubMed Scopus (53) Google Scholar This displacement then stretches the intracranial pain-sensitive dura, sinuses and blood vessels, causing pain. Typical PDPH may occur soon after spinal anaesthesia and usually subsides in a few days with bed rest and analgesia. Recently, Suess and colleagues found that headache lasting >5 days was the chief complaint in 17 reported cases of intracranial haemorrhage after myelography.9Suess O Stendel R Baur S et al.Intracranial haemorrhage following lumbar myelography: case report and review of the literature.Neuroradiology. 2000; 42: 211-214Crossref PubMed Scopus (40) Google Scholar Macon and colleagues reported that headache of subdural haematoma was more severe than PDPH and persistent, even in the recumbent position.10Macon ME Armstrong L Brown EM Subdural hematoma following spinal anesthesia.Anesthesiology. 1990; 72: 380-381Crossref PubMed Scopus (42) Google Scholar PDPH was the most frequently encountered complication with traditional Quincke point spinal needles of large size. Its incidence has been minimized with the use of 29G needles11Flaaten H Rodt SA Vamnes J et al.Post-dural puncture headaches: a comparison between 26 and 29G needles in young patients.Anaesthesia. 1989; 44: 147-149Crossref PubMed Scopus (115) Google Scholar and pencil-point needles.12Hart JR Whitacre RJ Pencil point needle in prevention of post spinal headache.J Am Med Assoc. 1951; 147: 657-658Crossref PubMed Scopus (110) Google Scholar Epidural blood patching has been described for stopping CSF leakage, thereby relieving the headache.13Abouleish E Vega S Blendinger I et al.Long-term follow-up of epidural blood patch.Anesth Analg. 1975; 54: 459-463Crossref PubMed Scopus (183) Google Scholar Subdural haematomas have occurred after lumbar puncture in association with cerebral aneurysm, brain tumour, recent cerebrovascular accident and meningovascular syphilis. It is postulated that the haemorrhage is caused by a sudden decrease in intracranial pressure consequent to the loss of CSF at the lumbar puncture site. Sudden caudal shift of the brain may cause traction on the arachnoid mater and/or venous structures and may lead to bleeding from ruptured vessels. Thorsen has described multiple petechial haemorrhages on the surface of the brain after spinal anaesthesia.14Thorsen G Neurological complications after spinal anaesthesia and results from 2,493 follow-up cases.Acta Chir Scand. 1947; 95: 1-272PubMed Google Scholar Pavlin and colleagues reported two cases of large subdural haematoma, which required surgical evacuation.1Pavlin DJ McDonald JS Child B et al.Acute subdural hematoma—an unusual sequela to lumbar puncture.Anesthesiology. 1979; 51: 338-340Crossref PubMed Scopus (66) Google Scholar Mantia reported a case of intracerebral haemorrhage after lumbar puncture with a 26G spinal needle; his patient improved with conservative treatment.5Mantia AM Clinical report of the occurrence of an intracerebral hemorrhage following post-lumbar puncture headache.Anesthesiology. 1981; 55: 684-685Crossref PubMed Scopus (54) Google Scholar The true incidence of subdural haematoma after dural puncture is not known. Most patients with headache are probably treated without investigation. Subdural haematomas are known to resolve spontaneously15Blake DW Donnan G Jensen D Intracranial subdural haematoma after spinal anaesthesia.Anaesth Intens Care. 1987; 15: 341-342Crossref PubMed Google Scholar but they may be catastrophic as evident from the deaths recorded as a complication of lumbar puncture.9Suess O Stendel R Baur S et al.Intracranial haemorrhage following lumbar myelography: case report and review of the literature.Neuroradiology. 2000; 42: 211-214Crossref PubMed Scopus (40) Google Scholar 16Newrick P Read D Subdural haematoma as a complication of spinal anaesthetics.Br Med J. 1982; 285: 341-342Crossref PubMed Scopus (59) Google Scholar In the case described here, the patient developed a subdural haematoma despite the use of a narrow gauge (23G) spinal needle. Altered CSF dynamics probably caused the rupture of a cerebral vein, resulting in the development of a subdural haematoma. Fortunately, the haematoma was only small and did not require surgical decompression. Severe and prolonged PDPH should be regarded as a warning sign of an intracranial haematoma. In these patients, early neurosurgical consultation is recommended." @default.
• W2105485865 created "2016-06-24" @default.
• W2105485865 creator A5013700417 @default.
• W2105485865 creator A5048222955 @default.
• W2105485865 creator A5071101610 @default.
• W2105485865 creator A5072504238 @default.
• W2105485865 date "2001-06-01" @default.
• W2105485865 modified "2023-10-03" @default.
• W2105485865 title "Cranial subdural haematoma after spinal anaesthesia" @default.
• W2105485865 cites W1598818627 @default.
• W2105485865 cites W1964775891 @default.
• W2105485865 cites W1966580308 @default.
• W2105485865 cites W1982664054 @default.
• W2105485865 cites W1995683556 @default.
• W2105485865 cites W2032769039 @default.
• W2105485865 cites W2068034017 @default.
• W2105485865 cites W2074082309 @default.
• W2105485865 cites W2075076686 @default.
• W2105485865 cites W2085991378 @default.
• W2105485865 cites W2103450119 @default.
• W2105485865 cites W2105567869 @default.
• W2105485865 cites W2473250651 @default.
• W2105485865 cites W4244236671 @default.
• W2105485865 doi "https://doi.org/10.1093/bja/86.6.893" @default.
• W2105485865 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/11573605" @default.
• W2105485865 hasPublicationYear "2001" @default.
• W2105485865 type Work @default.
• W2105485865 sameAs 2105485865 @default.
• W2105485865 citedByCount "69" @default.
• W2105485865 countsByYear W21054858652012 @default.
• W2105485865 countsByYear W21054858652013 @default.
• W2105485865 countsByYear W21054858652014 @default.
• W2105485865 countsByYear W21054858652015 @default.
• W2105485865 countsByYear W21054858652016 @default.
• W2105485865 countsByYear W21054858652017 @default.
• W2105485865 countsByYear W21054858652018 @default.
• W2105485865 countsByYear W21054858652019 @default.
• W2105485865 countsByYear W21054858652020 @default.
• W2105485865 countsByYear W21054858652021 @default.
• W2105485865 countsByYear W21054858652022 @default.
• W2105485865 countsByYear W21054858652023 @default.
• W2105485865 crossrefType "journal-article" @default.
• W2105485865 hasAuthorship W2105485865A5013700417 @default.
• W2105485865 hasAuthorship W2105485865A5048222955 @default.
• W2105485865 hasAuthorship W2105485865A5071101610 @default.
• W2105485865 hasAuthorship W2105485865A5072504238 @default.
• W2105485865 hasBestOaLocation W21054858651 @default.
• W2105485865 hasConcept C2776662227 @default.
• W2105485865 hasConcept C2992886682 @default.
• W2105485865 hasConcept C42219234 @default.
• W2105485865 hasConcept C71924100 @default.
• W2105485865 hasConceptScore W2105485865C2776662227 @default.
• W2105485865 hasConceptScore W2105485865C2992886682 @default.
• W2105485865 hasConceptScore W2105485865C42219234 @default.
• W2105485865 hasConceptScore W2105485865C71924100 @default.
• W2105485865 hasIssue "6" @default.
• W2105485865 hasLocation W21054858651 @default.
• W2105485865 hasLocation W21054858652 @default.
• W2105485865 hasOpenAccess W2105485865 @default.
• W2105485865 hasPrimaryLocation W21054858651 @default.
• W2105485865 hasRelatedWork W2040743001 @default.
• W2105485865 hasRelatedWork W2320666428 @default.
• W2105485865 hasRelatedWork W2330471292 @default.
• W2105485865 hasRelatedWork W2464987223 @default.
• W2105485865 hasRelatedWork W2797173093 @default.
• W2105485865 hasRelatedWork W2915432990 @default.
• W2105485865 hasRelatedWork W3087738690 @default.
• W2105485865 hasRelatedWork W3129981865 @default.
• W2105485865 hasRelatedWork W4234907590 @default.
• W2105485865 hasRelatedWork W4285601486 @default.
• W2105485865 hasVolume "86" @default.
• W2105485865 isParatext "false" @default.
• W2105485865 isRetracted "false" @default.
• W2105485865 magId "2105485865" @default.
• W2105485865 workType "article" @default.