Bilateral Subdural Hematoma Following Spinal Anesthesia for Cesarean Delivery: A Rare Complication of Post-Dural Puncture Headache

Spinal anesthesia is a widely used and preferred technique for cesarean delivery due to its safety and effectiveness, though complications like post-dural puncture headache (PDPH) are well-documented, with progression to bilateral subdural hematoma (SDH) being exceedingly rare. This report describes a 34-year-old woman with no prior medical history who underwent elective cesarean delivery under spinal anesthesia and developed a positional headache two days postoperatively, which later became constant and was accompanied by right hemiparesis and visual disturbances. Brain imaging confirmed bilateral SDH, and the patient was managed conservatively with analgesics, corticosteroids, and supportive care, achieving full functional recovery with no significant neurological deficits at three months. This case highlights the importance of early recognition of neurological symptoms and prompt imaging in patients with persistent or worsening postoperative headaches, emphasizing the need for clinicians to consider SDH as a potential complication of PDPH.