Anesth Pain Med.  2012 Jul;7(3):262-265.

A case of pneumocephalus during labor epidural analgesia: A case report

• Son JH
• Jee YS
• Shin YC
• Yoon HJ
• Lee IH
• Jeon JY

Abstract

Pneumocephalus can be developed after a dural puncture, which occurs in association with epidural procedures. A 37-year-old, gestational age 40 weeks, pregnant woman was admitted for vaginal delivery. She asked for epidural analgesia when she suffers with labor pain. Epidural anesthesia was done at the L3-L4 interspace with the loss of resistance technique, using air. During the identification of the epidural space, an accidental dural puncture was diagnosed by observing a free flow of CSF, through the needle. The patient developed headache 2 hours later. She was treated with hydration, oxygen, analgesics and the autologus blood patch procedure was done, at the L4-L5 interspace. Despite these measures, the patient's symptoms worsened with nausea and vomiting. A brain CT scan showed the presence of pneumocephalus. After 100% oxygen therapy and metoclopramide injection, she was discharged on postpartum 2 days, without any complications.

Keyword

Autologus blood patch; Epidural anesthesia; Headache; Pneumocephalus

MeSH Terms

Adult
Analgesia, Epidural
Analgesics
Anesthesia, Epidural
Brain
Epidural Space
Female
Gestational Age
Headache
Humans
Labor Pain
Metoclopramide
Nausea
Needles
Oxygen
Pneumocephalus
Postpartum Period
Pregnancy
Pregnant Women
Punctures
Vomiting
Analgesics
Metoclopramide
Oxygen