Introduction: An acute subdural hematoma is a collection of blood in the space between the dural and arachnoid membranes overlying the brain. Head trauma is the most common cause. Less frequently, low cerebrospinal fluid pressure, due to a spontaneous or iatrogenic cerebrospinal fluid leak can result in a subdural hematoma.
Case Report: We discuss the case of a 26-year-old woman who presented with a frontal headache following epidural anesthesia for vaginal delivery. The differential diagnosis included spinal headache, postpartum hypercoagulability, dural sinus thrombosis, and intracranial hemorrhage or mass. Her vital signs and physical examination were normal. A computed tomography of the brain revealed an acute subdural hematoma along the left frontal cerebral hemisphere, without midline shift or mass effect. A blood patch was placed with complete resolution of her symptoms.
Conclusion: This case illustrates an unusual case of an acute subdural hematoma in the postpartum period following epidural anesthesia for labor pain management. It was thought to be caused by intracranial hypotension following epidural anesthesia and a cerebrospinal fluid leak.
Introduction: We present the case of a patient with a spontaneous cervical epidural hematoma that presented with neck pain and mild, left arm parasthesia.
Case Report: A 59-year old man presented with sudden onset of severe neck pain, without history of injury or trauma. The patient also complained of associated left arm parasthesias that progressed to left arm and leg weakness while in the emergency department. Multiple diagnoses were considered and worked up; eventually the correct diagnosis was made with magnetic resonance imaging of the cervical spine.
Conclusion: Spontaneous cervical epidural hematoma typically presents with neck pain, and variable neurologic complaints. This case illustrates the challenge in making this uncommon but serious diagnosis.
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