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Anesth Analg 2004;99:1218-1220
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000134814.93305.F8

OBSTETRIC ANESTHESIA

The Diagnosis and Treatment of a Patient with Puerperal Infection and Subdural Hygromas

Natàlia Aragonès, MD*, Antoni Arxer, MD*, María Vieito, MD*, Josefina Ros, MD*, Antonio Villalonga, MD PhD*, and Xavier Ustrell, MD{dagger}

Departments of *Anesthesiology and {dagger}Neurology, Girona, Catalonia, Spain

Address correspondence and reprint requests to Natàlia Aragonès, Department of Anesthesia, Hospital Universitari Doctor Josep Trueta, Av. de França s/n. 17007, Girona, Spain. Address email to anestesia{at}htrueta.scs.es

We describe a patient readmitted after developing a persistent postural headache resulting from an accidental lumbar puncture during labor 10 days earlier. Magnetic resonance imaging demonstrated bifrontal subdural hygromas and diffuse pachymeningeal enhancement. The patient had signs of a puerperal infection, and an epidural patch was performed with dextran 40 instead of blood, after which gradual improvement was noted. The patient was discharged totally asymptomatic 3 days later.

IMPLICATIONS: We describe a puerperal patient with persistent postural headache after accidental lumbar puncture in which magnetic resonance imaging showed subdural hygromas. The condition was successfully treated with an epidural patch using dextran 40.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.