# Management of Labor and Anesthesia in a Patient With a History of Spontaneous Intracranial Hypotension: A Case Report With Literature Review

## TL;DR

This case report discusses the challenges of managing labor and anesthesia for a pregnant woman with a history of spontaneous intracranial hypotension.

## Contribution

The paper provides a case-based review of delivery and anesthesia strategies for pregnant women with a history of SIH.

## Key findings

- An emergency cesarean section under general anesthesia was performed for a patient with a history of SIH.
- There are no established guidelines for managing delivery and anesthesia in pregnant women with SIH.
- Treatment strategies should be tailored to the patient's preferences and institutional protocols.

## Abstract

Spontaneous intracranial hypotension (SIH) is a rare disorder characterized by continuous or intermittent cerebrospinal fluid (CSF) leakage from the CSF cavity, which causes symptoms such as headache or neck pain upon standing. However, no well-established measures concerning the type of delivery and anesthesia for pregnant women with a history of SIH have been reported. A woman had developed SIH 9 years earlier from lifting luggage into an overhead bin with stretching movements, which required continuous saline epidural infusion for recovery. Upon the patient’s pregnancy at the age of 35 years, although an elective cesarean section (CS) under general anesthesia was planned to avoid SIH recurrence, the patient had an emergency CS at 36 weeks. Since there is no prescribed method of delivery and anesthetic management for patients with a history of SIH, it is important to plan and adapt a treatment strategy based on the patient’s wishes and the institution’s protocols. As a sidenote, we reviewed the available literature regarding the type of delivery and anesthesia for pregnant women with a history of SIH.