Pneumocephalus during continuous epidural block.
We report a case of pneumocephalus during continuous epidural infusion. A 52-year-old malnourished man with rectal cancer had been treated with continuous epidural block for the relief of pain in the left thigh. Eleven days after catheter insertion, a dull, persistent headache occurred in the frontal region, and it worsened gradually. It was precipitated by any head motion and was not relieved by the supine position. A head computed tomography (CT) scan taken 3 days after the onset of the headache revealed about 15 ml of intracranial air and backward compression of the brain. The catheter was removed and the patient maintained bed-rest. The headache disappeared 2 days later. It is speculated that the air was sucked in through the space along the epidural catheter.
Kasai
Kyomi
K
Department of Anesthesia, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, 524-8524, Japan.
Osawa
Masami
M
D015360:Analgesia, Epidural / Q000009:adverse effects* / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D006257:Head / Q000000981:diagnostic imaging; D006261:Headache / Q000209:etiology; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D009407:Nerve Block / Q000009:adverse effects* / Q000379:methods; D010146:Pain / Q000517:prevention & control; D011007:Pneumocephalus / Q000175:diagnosis / Q000209:etiology*; D012004:Rectal Neoplasms / Q000150:complications*; D014057:Tomography, X-Ray Computed / Q000379:methods
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D002045:Bupivacaine