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Pneumocephalus secondary to epidural analgesia: a case report

INTRODUCTION: Epidural anesthesia is commonly used for analgesia during labor, and headache is a common complaint following this procedure. Pneumocephalus, on the other hand, is a rare and potentially serious complication of epidural anesthesia, which is most often caused by accidental puncture of t...

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Autores principales: Ahmad, Maira, Bellamy, Shannay, Ott, William, Mekhail, Rany
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10214711/
https://www.ncbi.nlm.nih.gov/pubmed/37231513
http://dx.doi.org/10.1186/s13256-023-03955-5
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author Ahmad, Maira
Bellamy, Shannay
Ott, William
Mekhail, Rany
author_facet Ahmad, Maira
Bellamy, Shannay
Ott, William
Mekhail, Rany
author_sort Ahmad, Maira
collection PubMed
description INTRODUCTION: Epidural anesthesia is commonly used for analgesia during labor, and headache is a common complaint following this procedure. Pneumocephalus, on the other hand, is a rare and potentially serious complication of epidural anesthesia, which is most often caused by accidental puncture of the dura with the introduction of air into intrathecal space. CASE PRESENTATION: We present the case of a 19-year-old Hispanic female who developed a severe frontal headache and neck pain eight hours following epidural catheter placement to deliver analgesia during labor. Physical examination was within normal limits without any neurological deficits. Computed tomography of the head and neck would later demonstrate small to moderate amounts of pneumocephalus, predominantly within the frontal horn of the lateral ventricles, and a moderate amount of air within the spinal canal. She was treated conservatively with analgesia. Though headache recurred after discharge, repeat imaging showed improvement in the volume of pneumocephalus and conservative management was continued. CONCLUSIONS: Although a rare complication and an uncommon cause of headache following epidural anesthesia, a high index of suspicion must remain for pneumocephalus as it may cause significant morbidity and, in some cases, be potentially life-threatening.
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spelling pubmed-102147112023-05-27 Pneumocephalus secondary to epidural analgesia: a case report Ahmad, Maira Bellamy, Shannay Ott, William Mekhail, Rany J Med Case Rep Case Report INTRODUCTION: Epidural anesthesia is commonly used for analgesia during labor, and headache is a common complaint following this procedure. Pneumocephalus, on the other hand, is a rare and potentially serious complication of epidural anesthesia, which is most often caused by accidental puncture of the dura with the introduction of air into intrathecal space. CASE PRESENTATION: We present the case of a 19-year-old Hispanic female who developed a severe frontal headache and neck pain eight hours following epidural catheter placement to deliver analgesia during labor. Physical examination was within normal limits without any neurological deficits. Computed tomography of the head and neck would later demonstrate small to moderate amounts of pneumocephalus, predominantly within the frontal horn of the lateral ventricles, and a moderate amount of air within the spinal canal. She was treated conservatively with analgesia. Though headache recurred after discharge, repeat imaging showed improvement in the volume of pneumocephalus and conservative management was continued. CONCLUSIONS: Although a rare complication and an uncommon cause of headache following epidural anesthesia, a high index of suspicion must remain for pneumocephalus as it may cause significant morbidity and, in some cases, be potentially life-threatening. BioMed Central 2023-05-26 /pmc/articles/PMC10214711/ /pubmed/37231513 http://dx.doi.org/10.1186/s13256-023-03955-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Ahmad, Maira
Bellamy, Shannay
Ott, William
Mekhail, Rany
Pneumocephalus secondary to epidural analgesia: a case report
title Pneumocephalus secondary to epidural analgesia: a case report
title_full Pneumocephalus secondary to epidural analgesia: a case report
title_fullStr Pneumocephalus secondary to epidural analgesia: a case report
title_full_unstemmed Pneumocephalus secondary to epidural analgesia: a case report
title_short Pneumocephalus secondary to epidural analgesia: a case report
title_sort pneumocephalus secondary to epidural analgesia: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10214711/
https://www.ncbi.nlm.nih.gov/pubmed/37231513
http://dx.doi.org/10.1186/s13256-023-03955-5
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