Epidural Headache Causing Life Threatening Subdural Hematoma. Norman's Story
"Of note, a change in headache pattern should alert the physician to the possibility of development of complications, such as subdural hematoma or cerebral venous thrombosis (Lai et al 2007b; Schievink and Maya 2008)."
The cerebrospinal fluid (CSF) cushions the brain and nerves in the spine. A puncture in the dura surrounding the spine (which happens about 1% of the time in epidural analgesia) can result in a leak of this fluid. Low CSF stretches and distorts sensitive brain structures that normally float on this fluid cushion and can cause headaches. In rare but dangerous cases low CSF can cause bleeding in the brain.
This is what happened
to me, and my doctors were unaware of this danger. I received epidural
analgesia for abdominal surgery, and developed epidural headaches a
couple of days later and was sent home and told to wait them out with caffein/painkillers. After about 10 days the nature of the headaches
changed -- I now had them when I first lay down, rather than when I
stood up for awhile. A few days later I had brief stroke-like symptoms
(TIA). The anesthesiologist dismissed these as having nothing to do with
the epidural and told me to see my primary care doctor. He in turn
thought it unlikely my symptoms were neurological in origin. I had a car
accident on the way home from seeing him, because I became confused
about which pedal was the brake.
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