Abstract
Background: Chronic subdural heamatoma (CSDH) is a disease that predominantly occurs in the elderly population. This is because of physiological atrophy of the brain parenchyma and frailty which leads to higher risk of falls. CSDH is unusual in the younger population but can be seen in the context of impact injuries in the younger population and mostly in males. Case Reports: We describe CSDH in 4 young postpartum mothers with no history of trauma. All had cesarean section births under spinal anaesthesia. The 4 mothers’ ages range from 24 years to 32 years. They presented with persistent post-dural puncture headaches with 2 of the mothers having focal neurological deficits. They presented between 4 weeks and 6 weeks after cesarean section. Three mothers underwent burrhole evacuation with one mother having a craniotomy. All recovered after surgery. Conclusion: Spinal anaesthesia and disruption of the CSF dynamics is the only identifiable risk factors in these young mothers. A longitudinal follow-up of mothers undergoing spinal anaesthesia should be done to document the incidence of CSDH in postpartum mothers.
Highlights
Chronic subdural heamatoma (CSDH) is a disease that predominantly occurs in the elderly population
This is because of physiological atrophy of the brain parenchyma and frailty which leads to higher risk of falls
The 4 mothers’ ages range from 24 years to 32 years. They presented with persistent post-dural puncture headaches with 2 of the mothers having focal neurological deficits
Summary
This is because of physiological atrophy of the brain parenchyma and frailty which leads to higher risk of falls. CSDH is unusual in the younger population but can be seen in the context of impact injuries in the younger population and mostly in males. The internal pressure dynamics of the skull contents are determined by a constant balance of all its elements. Changes in the CSF pressure dynamics have been shown to predispose the individual to the development of CSDH. Iatrogenic CSF diversion in coexisting hydrocephalus or lumbar drainage can cause CSDH. We describe 4 postpartum women with CSDH who we have managed within 1 year and describe their characteristics
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