Postpartum acute subdural hematoma; a probable complication of saddle block analgesia

The author present a patient who developed an acute intracranial subdural hematoma approximately 35 hours after an uncomplicated delivery under saddle block analgesia. The proposed mechanism is that of cerebrospinal fluid efflux through the lumbar puncture site during uterine contractions and straining; shift of the intracranial structures, especially veins; venous hypertension; venous rupture; and subdural hematoma formation.