11 Asymptomatic cerebrospinal fluid fistula following combined spinal-epidural anaesthesia in a healthy parturient

Background and Aims Cerebrospinal fluid (CSF) cutaneous fistula is a rare complication that can occur after a neuraxial anaesthesia technique. It can cause serious complications such as incapacitating headaches, cranial nerve symptoms, central nervous system infection and intracranial subdural hematoma.1 Methods Description of a case report in the section below. Results Case report: A healthy pregnant woman was subjected to a c-section after an uneventful combined spinal-epidural neuraxial block. On the second postoperative day, upon the removal of the epidural catheter, a fluid leakage was noticed emerging from the puncture site. The fluid was crystalline and had a measured glucose level of 83 mg/dL. The patient was completely asymptomatic. Following neurosurgery consultation, the leak site was sutured at the skin level after 24h of persistent leakage. The patient was discharged home the next day completely asymptomatic. She had the suture removed 3 days later, without any recurrence of the leakage. She didn´t report any symptoms during a two-month follow-up. Conclusions This report presents another case of a CSF fistula after a neuraxial block and highlights the success of a conservative approach that avoided not only a blood patch, but also a surgical procedure, in an asymptomatic young woman.