Subdural hematoma after microdiscectomy: a case report and review of the literature

Background contextSubdural hematomas (SDHs) have been described as a rare complication from durotomy after lumbar spine surgery. In half of the reported cases, the durotomy was unnoticed intraoperatively. The most common presenting symptom was persistent headache.PurposeTo report a case of SDH after routine microdiscectomy and to review the literature.Study designCase report and review of the literature.MethodsRetrospective review of patient's history and imaging studies.ResultsA 39-year-old female underwent routine microdiscectomy for L5–S1 herniated disc. There were no complications, and no dural tear was noted. Approximately 1 week postoperatively, the patient complained of severe headaches. Imaging revealed a right intracranial chronic SDH and a lumbar pseudomeningocele. Operative exploration of her lumbar wound revealed a dural tear, which was closed primarily. The patient had subsequent resolution of her SDH.ConclusionsThe authors present a case of a routine microdiscectomy complicated by delayed cerebrospinal leak causing a chronic SDH. This report illustrates the need for a comprehensive evaluation of headaches after spine surgery.