Dee, Fiona Jane

32y · Female·Hypoxic brain injury due to a combination of factors arising from subdural haematoma, including hyponatremia, cerebrospinal fluid leak, and epileptic seizure, all arising from spinal anaesthesia administered for caesarean section

A 32-year-old fit and healthy woman died from hypoxic brain injury following complications of spinal anaesthesia for caesarean section. She developed a subdural haematoma (rare complication) and persistent post-dural puncture headaches requiring rest. After discharge, her husband contacted the neurosurgeon twice expressing increasing concern about worsening headaches and new-onset vomiting. The neurosurgeon did not arrange for clinical review or hospitalisation. She deteriorated at home and presented with seizure, respiratory arrest, and profound hyponatraemia (likely from Tegretol). Clinical lessons: complex neurosurgical cases require multidisciplinary team communication; post-operative headaches with vomiting warrant urgent reassessment; patient and family concerns, especially repeated calls, demand careful listening and consideration of review; post-dural complications may coexist with other intracranial pathology. Earlier CT scan and blood tests on Saturday could have improved outcome chances.