Pneumocephalus following thoracic surgery: the implication of the epidural anesthesia is still exceptional.
Epidural analgesia is the gold standard for the management of pain after thoracopulmonary surgery. However, it is not without side-effects and complications. We report the case of a 52-year-old man who underwent left lower lobectomy for a carcinoid tumor. He received multimodal anesthesia combining epidural thoracic anesthesia and balanced intravenous general anesthesia. He presented with pneumocephalus on the 10th postoperative day. Etiological assessment consisted of isotopic cisternography and cerebromedullar magnetic resonance imaging (MRI), revealing a breach in the fourth left spinal dural nerve sheath. Although it was initially suspected, the thoracic epidural was eventually excluded as the cause. Management consisted of prompt surgical repair.
Gentile
Ariane
A
Department of Anesthesiology and Critical Care, Hôpital du Haut-Lévêque, Centre Hospitalier Universitaire (CHU) Bordeaux, Pessac, France.
Germain
Arnaud
A
Ouattara
Alexandre
A
Janvier
Gérard
G
D000767:Anesthesia, Epidural; D002276:Carcinoid Tumor / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008197:Lymph Node Excision / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011007:Pneumocephalus / Q000175:diagnosis / Q000209:etiology*; D011013:Pneumonectomy / Q000009:adverse effects*