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Extra-axial haemorrhage in a patient with Alport syndrome after epidural anaesthesia
  1. Shanika Wijayanayaka1,
  2. Abir Guha2,
  3. Kanapathippillai Sivanesan1 and
  4. Mayooran Veerasingham1
  1. 1Department of Obstetrics & Gynaecology, Ipswich Hospital, Ipswich, Queensland, Australia
  2. 2Department of Anaesthesia, Ipswich Hospital, Ipswich, Queensland, Australia
  1. Correspondence to Dr Shanika Wijayanayaka; shanika.wijayanayaka{at}


Extra-axial haemorrhage following epidural anaesthesia is extremely rare. We present the case of an 18-year-old G1P0 woman with Alport syndrome who had a ventouse delivery for failure to progress that was complicated by a postpartum tonic–clonic seizure. Clinically, and confirmed radiologically, the patient was found to have experienced an extra-axial haemorrhage (extradural and subdural haemorrhage) secondary to a cerebrospinal fluid leak caused by a dural puncture during epidural anaesthesia. Differentiating between postdural puncture headache, subdural haemorrhage and extradural haemorrhage can be extremely challenging, but it is important to consider these rare conditions when evaluating patients presenting with postpartum headache and seizure.

  • pregnancy
  • anaesthesia

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  • Contributors SW drafted the manuscript. AG contributed to review and editing of the manuscript. MV contributed to review and editing of the manuscript. KS contributed to review and editing of the manuscript. All authors contributed equally to creation of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.