Intracranial and intraspinal hemorrhage following spinal anesthesia

Raffaele Rocchi, Carolina Lombardi, Ilaria Marradi, Marco Di Paolo, Alfonso Cerase

Research output: Contribution to journalArticlepeer-review


Spinal anesthesia (SA), accounting for more than 50% of regional anesthesias in the spinal region, is generally perceived as simple and safe. Our purpose is to increase awareness of hemorrhagic complications following SA. A 69-year-old male without either coagulation disorders or anticoagulant/antiplatelet therapy developed acute radiculopathy, and severe mental confusion after SA for prostatectomy. CT showed intracranial subarachnoid and intraventricular acute hemorrhage. Cerebral angiography was negative. MRI showed subarachnoid and subdural hematoma in the dorsolumbar spine. Seven-year follow-up showed permanent cognitive and radicular damage. Multiple attempts for SA most likely caused spinal vessels rupture, either directly or indirectly by inducing differential pressure changes between cerebrospinal fluid and intravascular spaces; however, definite mechanisms have not been completely understood. Patients undergoing spinal puncture must report any neurological abnormality, which may result in irreversible damage. Cases of altered consciousness require an extensive neuroradiological evaluation. Proper competency of physicians responsible for spinal puncture is mandatory.

Original languageEnglish
Pages (from-to)393-396
Number of pages4
JournalNeurological Sciences
Issue number5
Publication statusPublished - 2009


  • Computed tomography
  • Intraventricular hemorrhage
  • Magnetic resonance imaging
  • Neurological complications
  • Spinal anesthesia
  • Spinal hematoma
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Dermatology


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