TITLE:
Chronic Subdural Hematoma, a Cause of Persistent Post-Dural Puncture Headache in the Postpartum Period
AUTHORS:
Daniel Kanyata, Omar Ahmed Nassir, Christopher K. Musau, Victoria Adhiambo Gamba, Mariatu Tamimu, Michelle Gathecha, Lily Nyamai
KEYWORDS:
Case Report, Post Dural Puncture Headache
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.3,
March
18,
2021
ABSTRACT: Background: Chronic subdural heamatoma (CSDH) is a disease that predominantly occurs
in the elderly population. This is because of physiological atrophy of the
brain parenchyma and frailty which leads to higher risk of falls. CSDH is unusual in the
younger population but can be seen in the context of impact injuries in the
younger population and mostly in males. Case Reports: We describe CSDH in 4 young
postpartum mothers with no history of trauma. All had cesarean section births under
spinal anaesthesia. The 4 mothers’ ages range from 24 years to 32 years. They presented with persistent post-dural
puncture headaches with 2 of the mothers having focal neurological deficits.
They presented between 4 weeks and 6 weeks after cesarean section. Three
mothers underwent burrhole evacuation with
one mother having a craniotomy. All recovered after surgery. Conclusion: Spinal anaesthesia and disruption of the CSF dynamics is the only
identifiable risk factors in these young mothers. A longitudinal follow-up of
mothers undergoing spinal anaesthesia should be done to document the incidence
of CSDH in postpartum mothers.