A multidisciplinary approach to management of a non-traumatic subdural hematoma in the third trimester of pregnancy: A case report and review of literature

Key message: Although non-traumatic SDHs are uncommon during and immediately following pregnancy, management of these cases should be carried out by a multidisciplinary team, including obstetricians, pediatricians, neurosurgeons, and anesthesiologists.

Abstract: Intracranial hemorrhage represents an uncommon but serious complication of pregnancy. Non-traumatic subdural hematomas (SDH) are uncommon during the prenatal period with limited literature about etiology and management. In this case report, the authors report on a patient with non-traumatic SDH in the third trimester of pregnancy. The patient is a 40-year-old G6P5L5 female at gestational age of 34 weeks and 5 days presenting with frontal headache, nausea, vomiting, and blurry vision. CT scan revealed an acute on chronic right subdural hematoma with midline shift and multiple herniations. An emergency cesarean section and right burr hole SDH evacuation were performed. Etiology of the SDH remains unknown. Although non-traumatic SDHs are uncommon during and immediately following pregnancy, health care providers should always consider this possibility if a patient presents with typical symptoms and signs. Management of these cases should be carried out by a multidisciplinary team, including obstetricians, pediatricians, neurosurgeons, and anesthesiologists to optimize maternal and fetal outcomes.