Pneumocephalus as a cause for headache.
BACKGROUND
Pneumocephalus can be a cause of headache, but is easily overlooked in some clinical circumstances.


METHODS
A 35-year-old woman developed severe headache of abrupt onset during an epidural blood patch procedure done for a post-lumbar puncture headache. A brain CT scan showed subarachnoid air even though there was no evidence of a dural puncture having occurred during the procedure.


RESULTS
The experience of our patient, and a review of the literature suggests that air injected into the epidural space during use of the "loss of resistance" technique can enter the subarachnoid space if a dural puncture site from a previous lumbar puncture is present.


CONCLUSIONS
Pneumocephalus should be considered as a potential cause for a severe headache occurring in association with epidural procedures, and also in a number of other clinical settings. Use of a high inspired air oxygen concentration can hasten absorption of an intracranial air collection.
University of Calgary and Calgary Health Region, Calgary, Alberta, Canada.
W J
WJ
Becker
D000328:Adult; D017217:Blood Patch, Epidural / Q000009:adverse effects*; D004824:Epidural Space / Q000503:physiopathology; D005260:Female; D006261:Headache / Q000209:etiology*; D006801:Humans; D011007:Pneumocephalus / Q000150:complications* / Q000209:etiology; D013129:Spinal Puncture / Q000009:adverse effects; D013346:Subarachnoid Space / Q000503:physiopathology; D014057:Tomography, X-Ray Computed