Multiple territory watershed infarcts following spinal anaesthesia

Area of Science:

• Anesthesiology
• Neurology
• Vascular Medicine

Background:

• Hypotension is a frequent complication of spinal anesthesia (SA), associated with increased morbidity and mortality.
• Managing intraoperative blood pressure is crucial for patient safety during SA procedures.

Observation:

• A previously healthy woman with vascular disease risk factors experienced a severe hypotensive event during SA.
• The patient subsequently developed multiple watershed infarcts, indicative of widespread cerebral hypoperfusion.

Findings:

• The case illustrates a devastating stroke directly linked to hypotension following SA.
• The patient's condition deteriorated, leading to death from aspiration pneumonia 14 days post-hospitalization.

Implications:

• This case underscores the critical importance of vigilant blood pressure monitoring and management during SA.
• Awareness of SA-induced hypotension risks is vital for preventing severe neurological complications and improving patient outcomes.
• Healthcare providers should consider pre-existing vascular risk factors when assessing patients for SA.