Bilateral abducens nerve palsy from post-spinal-anesthesia-induced bilateral chronic subdural hematoma: case report
BackgroundA chronic cranial subdural hematoma arising after post-spinal anesthesia is a rare but serious and life-threatening complication of spinal anesthesia. It usually mimics the typical post-spinal-anesthesia headache or post-dural-puncture headache, potentially masking its detection. Abducens...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Anesthesiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fanes.2023.1237981/full |
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| author | Mestet Yibeltal Shiferaw Tsegazeab Laeke T/Mariam Abenezer Tirsit Aklilu Kibruyisfaw Zewudie Shumbash Yemisirach Bizuneh Akililu Bethelhem Yishak Worku Mengistu Ayele |
| author_facet | Mestet Yibeltal Shiferaw Tsegazeab Laeke T/Mariam Abenezer Tirsit Aklilu Kibruyisfaw Zewudie Shumbash Yemisirach Bizuneh Akililu Bethelhem Yishak Worku Mengistu Ayele |
| author_sort | Mestet Yibeltal Shiferaw |
| collection | DOAJ |
| description | BackgroundA chronic cranial subdural hematoma arising after post-spinal anesthesia is a rare but serious and life-threatening complication of spinal anesthesia. It usually mimics the typical post-spinal-anesthesia headache or post-dural-puncture headache, potentially masking its detection. Abducens nerve palsy tends to occur in chronic subdural hematoma of post-dural-puncture etiology rather than in cases attributed to other causes of subdural hematoma. Preferential damage to the abducens nerve is frequent and can be attributed to its anatomic course because the abducens nerve runs in the direction of the typical caudad displacement of the brain related to intracranial hypotension.ObservationHere, we present a report on the clinical presentation, pathogenesis, and management of two cases that developed bilateral abducens nerve palsy following post-spinal anesthesia administered for cesarean sections due to obstetric indications.LessonPost-spinal-anesthesia-induced chronic subdural hematoma, although a rare, life-threatening complication, must be differentiated from post-spinal-anesthesia headache and treated surgically. Cranial nerve palsy (more commonly called abducens nerve palsy) is more common in post-spinal-anesthesia-induced subdural hematoma than subdural hematomas of other etiologies as the cerebrospinal fluid brain cushioning is partly lost. Cranial nerve palsies resolve in most cases if surgery is performed in a timely manner. |
| first_indexed | 2024-03-09T02:00:25Z |
| format | Article |
| id | doaj.art-23221797fb55406b8aba36cd003132c3 |
| institution | Directory Open Access Journal |
| issn | 2813-480X |
| language | English |
| last_indexed | 2024-03-09T02:00:25Z |
| publishDate | 2023-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Anesthesiology |
| spelling | doaj.art-23221797fb55406b8aba36cd003132c32023-12-08T05:18:18ZengFrontiers Media S.A.Frontiers in Anesthesiology2813-480X2023-12-01210.3389/fanes.2023.12379811237981Bilateral abducens nerve palsy from post-spinal-anesthesia-induced bilateral chronic subdural hematoma: case reportMestet Yibeltal ShiferawTsegazeab Laeke T/MariamAbenezer Tirsit AkliluKibruyisfaw Zewudie ShumbashYemisirach Bizuneh AkililuBethelhem Yishak WorkuMengistu AyeleBackgroundA chronic cranial subdural hematoma arising after post-spinal anesthesia is a rare but serious and life-threatening complication of spinal anesthesia. It usually mimics the typical post-spinal-anesthesia headache or post-dural-puncture headache, potentially masking its detection. Abducens nerve palsy tends to occur in chronic subdural hematoma of post-dural-puncture etiology rather than in cases attributed to other causes of subdural hematoma. Preferential damage to the abducens nerve is frequent and can be attributed to its anatomic course because the abducens nerve runs in the direction of the typical caudad displacement of the brain related to intracranial hypotension.ObservationHere, we present a report on the clinical presentation, pathogenesis, and management of two cases that developed bilateral abducens nerve palsy following post-spinal anesthesia administered for cesarean sections due to obstetric indications.LessonPost-spinal-anesthesia-induced chronic subdural hematoma, although a rare, life-threatening complication, must be differentiated from post-spinal-anesthesia headache and treated surgically. Cranial nerve palsy (more commonly called abducens nerve palsy) is more common in post-spinal-anesthesia-induced subdural hematoma than subdural hematomas of other etiologies as the cerebrospinal fluid brain cushioning is partly lost. Cranial nerve palsies resolve in most cases if surgery is performed in a timely manner.https://www.frontiersin.org/articles/10.3389/fanes.2023.1237981/fullabducens palsychronic subdural hematomapost-dural puncture headachespinal anesthesiasphenopalatine ganglion blocksubdural hematoma abducens palsy |
| spellingShingle | Mestet Yibeltal Shiferaw Tsegazeab Laeke T/Mariam Abenezer Tirsit Aklilu Kibruyisfaw Zewudie Shumbash Yemisirach Bizuneh Akililu Bethelhem Yishak Worku Mengistu Ayele Bilateral abducens nerve palsy from post-spinal-anesthesia-induced bilateral chronic subdural hematoma: case report Frontiers in Anesthesiology abducens palsy chronic subdural hematoma post-dural puncture headache spinal anesthesia sphenopalatine ganglion block subdural hematoma abducens palsy |
| title | Bilateral abducens nerve palsy from post-spinal-anesthesia-induced bilateral chronic subdural hematoma: case report |
| title_full | Bilateral abducens nerve palsy from post-spinal-anesthesia-induced bilateral chronic subdural hematoma: case report |
| title_fullStr | Bilateral abducens nerve palsy from post-spinal-anesthesia-induced bilateral chronic subdural hematoma: case report |
| title_full_unstemmed | Bilateral abducens nerve palsy from post-spinal-anesthesia-induced bilateral chronic subdural hematoma: case report |
| title_short | Bilateral abducens nerve palsy from post-spinal-anesthesia-induced bilateral chronic subdural hematoma: case report |
| title_sort | bilateral abducens nerve palsy from post spinal anesthesia induced bilateral chronic subdural hematoma case report |
| topic | abducens palsy chronic subdural hematoma post-dural puncture headache spinal anesthesia sphenopalatine ganglion block subdural hematoma abducens palsy |
| url | https://www.frontiersin.org/articles/10.3389/fanes.2023.1237981/full |
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