Postpartum cerebral ischaemia after accidental dural puncture and epidural blood patch.
case_report · Level V
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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.
Medical subject headings
- Blood Patch, Epidural
- Brain Ischemia
- Dura Mater
- Puerperal Disorders
- Wounds, Penetrating