Inadvertent dural puncture during attempted thoracic epidural catheter placement complicated by cerebral and spinal subdural hematoma

Narouze, Samer N.; Casanova, Jose; El-Jaberi, Mohammed; Farag, Ehab; Tetzlaff, John E.

doi:10.1016/j.jclinane.2005.05.006

« Previous Next »Journal of Clinical Anesthesia
Volume 18, Issue 2 , Pages 132-134, March 2006

Inadvertent dural puncture during attempted thoracic epidural catheter placement complicated by cerebral and spinal subdural hematoma

Samer N. Narouze, MD
- Department of Anesthesiology, Aultman Health Foundation, Canton, OH, USA
Jose Casanova, MD, PhD
- Department of Neurology, Aultman Health Foundation, Canton, OH, USA
Mohammed El-Jaberi, MD
- Department of Neurology, Aultman Health Foundation, Canton, OH, USA
Ehab Farag, MD, FRCA (Staff)
- Department of General Anesthesiology, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA
John E. Tetzlaff, MD (Professor, Director)
- The Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH 44710, USA
- Center for Anesthesiology Education, Division of Anesthesiology and Critical Care Medicine, The Cleveland Clinic Foundation, Cleveland, OH, USA
- Corresponding author. Department of General Anesthesiology, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. Tel.: +1 216 444 3739; fax: +1 216 444 9247.

Received 2 August 2004; accepted 16 May 2005.

Abstract

Minor complications of inadvertent dural puncture during attempted epidural anesthesia are common, related to the size of the needle and the incidence of postdural puncture headache. Serious complications are much less common. We report a case where inadvertent dural puncture with an 18-gauge epidural needle was associated with the creation of intracranial and spinal subdural hematoma.

Keywords: Anesthesia, regional, Anesthesia, epidural, Dural puncture, Subdural hematoma, Anesthesia, complications