title: Pneumocephalus following inadvertent intrathecal puncture during epidural anesthesia: a case report and review of the literature.
abstract: Regional anesthesia techniques (epidural and spinal) are preferred anesthetic modalities in modern obstetrics, in that both of these modalities enable maternal participation in the delivery process and assist in avoiding maternal aspiration associated with general anesthesia. We report an unusual and potentially severe complication of epidural anesthesia for elective repeat cesarean delivery. Following intravenous hydration and lateral uterine displacement, uneventful epidural anesthesia was administered. Toward the end of the otherwise uneventful cesarean the patient, who had been completely stable, became unresponsive, with dilated pupils that did not respond to light. The patient was immediately intubated and gradually regained consciousness and was extubated within 1 h. Cranial computed tomography disclosed pneumocephalus. Inadvertent pneumocephalus is reviewed.
authors.affiliation: Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Sherer
authors.forename: C I
authors.initials: CI
authors.lastname: Onyeije
authors.forename: E
authors.initials: E
authors.lastname: Yun
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007268:Injections, Epidural / Q000009:adverse effects*; D011007:Pneumocephalus / Q000000981:diagnostic imaging / Q000209:etiology*; D011247:Pregnancy; D014057:Tomography, X-Ray Computed