34 Subarachnoid hematoma after attempted spinal block

Background and Aims Subarachnoid hematoma is a rare but potentially serious complication of a subarachnoid block. Its occurrence is associated with several risk factors such as multiple spinal attempts, traumatic puncture and concurrent therapy with anticoagulants and/or antiplatelet agents.1 Methods Description of a case report in the section below. Results Case Report: A healthy pregnant woman was admitted for an elective c-section under subarachnoid spinal block. After two hematic punctures at different lumbar levels, it was decided to proceed with a general anaesthesia instead. Surgery was performed with no reports of complications. About 7 days later, the patient reported neurologic symptoms and a spinal hematoma was diagnosed (figure 1 and 2). After consultation with a neurosurgical team, a conservative approach was decided upon. The patient was admitted to the hospital for close monitoring of neurological signs and throughout the 12 days of in-hospital stay, there was a spontaneous remission of symptoms as well as a significant reduction in the size of the hematoma, confirmed by magnetic resonance imaging. The patient was discharged home assymptomatic. Conclusions Although the recommended treatment for a subarachnoid hematoma is an emergent surgical decompression, there have been reports of small subarachnoid hematomas associated with mild pain complaints that are conservatively managed with satisfactory results.2