Postpartum cerebral ischaemia after accidental dural puncture and epidural blood patch

Br J Anaesth. 2003 Jan;90(1):98-100.

Abstract

Puerperal women are reported to have a rate of cerebral infarction 13 times greater than non-pregnant females. We report a case of cerebral ischaemia in a 30-yr-old healthy parturient after epidural analgesia for labour, complicated by dural puncture treated with two epidural blood patches. Investigations showed the development of cerebral ischaemia on postpartum day 14. A transcranial Doppler ultrasonography showed vasospasm of the left middle cerebral artery still present at 3-month follow-up. At 1-yr follow-up, the patient had homonymous hemianopsia. We discuss the possible causative mechanism of the cerebral ischaemia in relation to the dural puncture and epidural blood patch.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Analgesia, Epidural / adverse effects
  • Analgesia, Obstetrical / adverse effects
  • Blood Patch, Epidural / adverse effects*
  • Brain Ischemia / etiology*
  • Dura Mater / injuries*
  • Female
  • Headache Disorders / etiology
  • Humans
  • Pregnancy
  • Puerperal Disorders / etiology*
  • Wounds, Penetrating / complications*