RT Journal Article SR Electronic T1 Extra-axial haemorrhage in a patient with Alport syndrome after epidural anaesthesia JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e242160 DO 10.1136/bcr-2021-242160 VO 14 IS 6 A1 Shanika Wijayanayaka A1 Abir Guha A1 Kanapathippillai Sivanesan A1 Mayooran Veerasingham YR 2021 UL http://casereports.bmj.com/content/14/6/e242160.abstract AB 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.