• Br J Anaesth · Jan 2003

    Case Reports

    Postpartum cerebral ischaemia after accidental dural puncture and epidural blood patch.

    • M Mercieri, A Mercieri, S Paolini, R Arcioni, D Lupoi, F Passarelli, G Pinto, and D Celleno.
    • Università di Roma La Sapienza, Ospedale S. Andrea, Rome, Italy. mamerx@yahoo.com
    • Br J Anaesth. 2003 Jan 1;90(1):98-100.

    AbstractPuerperal 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.

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