Unintentional subdural injection: a complication of neuraxial anesthesia/analgesia.

Unintentional subdural injection during neuraxial anesthesia/analgesia continues to be a challenge for anesthesiologists. This unusual complication is often poorly recognized, with the diagnosis made in retrospect, or not at all. The clinical presentation of these regional blocks can be heterogeneous, ranging from restricted, patchy, or unilateral sensory blockade all the way to extensive and even life-threatening motor and autonomic nervous system depression. Prompt diagnosis using clinical algorithms and radiographic imaging is crucial for the early discontinuation of the offending catheter. Supportive care is mandatory in cases involving severe depression of consciousness, motor function, and/or sympathetic tone.