Pneumocephalus following the treatment of a postdural puncture headache with an epidural saline infusion.
We report a case of pneumocephalus following the attempted treatment of a postdural puncture headache by a continuous epidural saline infusion. Within 1 hour of infusion, symptoms of a severe headache, nausea, and vomiting prompted a computerized tomographic scan of the head that showed 12 to 15 ml of air in the cranium. The epidural space was located easily with the loss-of-resistance technique using 3 ml of air. A saline bolus and infusion were initiated after confirmation of correct placement of the epidural catheter. We suggest that air passed from the negative-pressure epidural space through the dural puncture created by the diagnostic spinal tap, producing a pneumocephalus.
Vasdev
G M
GM
Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905.
Chantigian
R C
RC
D000328:Adult; D005260:Female; D006261:Headache / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007268:Injections, Epidural / Q000009:adverse effects; D009325:Nausea / Q000209:etiology; D011007:Pneumocephalus / Q000209:etiology*; D011247:Pregnancy; D012965:Sodium Chloride / Q000009:adverse effects*; D013129:Spinal Puncture / Q000009:adverse effects*; D014839:Vomiting / Q000209:etiology
D012965:Sodium Chloride