title: Acute onset headache complicating labor epidural caused by intrapartum pneumocephalus.
abstract: BACKGROUND
  Epidural placement for obstetric anesthesia is a common procedure. Pneumocephalus, the introduction of air into the cranial cavity after epidural placement, is a rare complication encountered when air is used for identification of the epidural space.
  
  
  METHODS
  A 42-year-old primipara undergoing epidural placement reported sudden onset of severe headache with associated neurologic symptoms and nuchal rigidity. Emergent CT scan revealed pneumocephalus. With conservative management, her symptoms resolved with interval resumption of the air collection evidenced on interval CT.
  
  
  CONCLUSIONS
  Acute onset headache after epidural placement can present with impressive neurologic signs and symptoms. Prompt identification of the cause of this pathology is of vital importance to delineate pneumocephalus from potentially treatable or life-threatening disorders.
authors.affiliation: Department of Obstetrics, Division of Maternal Fetal Medicine and Anesthesia, University of Miami School of Medicine/Jackson Memorial Hospital, Miami, FL 33101, USA.
authors.forename: Loren
authors.initials: L
authors.lastname: Smarkusky
authors.forename: Helena
authors.initials: H
authors.lastname: DeCarvalho
authors.forename: Ady
authors.initials: A
authors.lastname: Bermudez
authors.forename: Víctor Hugo
authors.initials: VH
authors.lastname: González-Quintero
mesh_terms: D000208:Acute Disease; D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects*; D016362:Analgesia, Obstetrical / Q000009:adverse effects*; D005260:Female; D005865:Gestational Age; D006261:Headache / Q000209:etiology*; D006801:Humans; D007751:Labor, Induced; D007743:Labor, Obstetric; D016239:MEDLINE; D008297:Male; D016104:Oligohydramnios; D011007:Pneumocephalus / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011247:Pregnancy; D011256:Pregnancy Outcome; D014057:Tomography, X-Ray Computed