Postdural puncture subdural hematoma or postdural puncture headache? -two cases report

Spinal anesthesia is widely used for many obstetric, gynecological, orthopedic, and urological operations. Subdural hematomasamay occur after trauma and are associated with high morbidity and mortality rates. Postdural puncture headachea(PDPH) is a benign condition and the most frequent complication of spinal anesthesia. The high rate of headacheaafter spinal anesthesia may mask or delay the diagnosis of subdural hematoma. The true incidence of postdural punctureasubdural hematoma (PDPSH) is unknown because most affected patients are probably managed without investigatioa. Therefore, the true incidence of PDPSH may be greater than suggested by previous reports. The differentiation of headache associated with subdural hematoma from PDPH is crucial. We herein report two cases of bilateral subdural hematoma after epidural anesthesia and emphasize the importance of suspicion for PDPSH and careful evaluation of patients with headache after spinal anesthesia. © the Korean Society of Anesthesiologists, 2015