Chronic Subdural Hematoma, a Cause of Persistent Post-Dural Puncture Headache in the Postpartum Period

Background: Chronic subdural heamatoma (CSDH) is a disease that predominantly occurs\r\nin the elderly population. This is because of physiological atrophy of the\r\nbrain parenchyma and frailty which leads to higher risk of falls. CSDH is unusual in the\r\nyounger population but can be seen in the context of impact injuries in the\r\nyounger population and mostly in males. Case Reports: We describe CSDH in 4 young\r\npostpartum mothers with no history of trauma. All had cesarean section births under\r\nspinal anaesthesia. The 4 mothers’ ages range from 24 years to 32 years. They presented with persistent post-dural\r\npuncture headaches with 2 of the mothers having focal neurological deficits.\r\nThey presented between 4 weeks and 6 weeks after cesarean section. Three\r\nmothers underwent burrhole evacuation with\r\none mother having a craniotomy. All recovered after surgery. Conclusion: Spinal anaesthesia and disruption of the CSF dynamics is the only\r\nidentifiable risk factors in these young mothers. A longitudinal follow-up of\r\nmothers undergoing spinal anaesthesia should be done to document the incidence\r\nof CSDH in postpartum mothers.