title: A rare case of pneumocephalus and pneumorrhachis after epidural anesthesia.
abstract: Both pneumocephalus and pneumorrhachis are rare but serious complications following epidural anesthesia. We report a rare case of simultaneous pneumocephalus and pneumorrhachis in a patient after undergoing epidural anesthesia. The patient lost consciousness and received emergent external ventricular drainage for pneumocephalus in another medical center. The patient was clear after external ventricular drain placement until 4 days later, when sudden onset of subdural hemorrhage occurred and an emergent craniectomy was performed. The patient passed away 2 days after craniectomy, due to multiorgan failure. Pneumocephalus with or without pneumorrhachis should be kept in mind when there is a sudden change of consciousness or persistent convulsions after epidural anesthesia.
authors.affiliation: Department of Anesthesiology, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan, ROC; Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Xhang-Xian
authors.initials: XX
authors.lastname: Hsieh
authors.affiliation: Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan, ROC; Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
authors.forename: Sun-Wung
authors.initials: SW
authors.lastname: Hsieh
authors.affiliation: Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Chueng-He
authors.initials: CH
authors.lastname: Lu
authors.affiliation: Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Zhi-Fu
authors.initials: ZF
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Da-Tong
authors.initials: DT
authors.lastname: Ju
authors.affiliation: Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Billy
authors.initials: B
authors.lastname: Huh
authors.affiliation: Graduate Institute of Mechanical and Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan, ROC.
authors.forename: Jia-Chang
authors.initials: JC
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC; Department of Anesthesiology, Keelung Branch, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC; Graduate Institute of Mechanical and Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan, ROC. Electronic address: cbkuli@gmail.com.
authors.forename: Chan-Yang
authors.initials: CY
authors.lastname: Kuo
mesh_terms: D000368:Aged; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D005260:Female; D006408:Hematoma, Subdural / Q000601:surgery; D006801:Humans; D011007:Pneumocephalus / Q000209:etiology*; D063205:Pneumorrhachis / Q000209:etiology*; D014057:Tomography, X-Ray Computed
keywords: anesthesia; epidural; pneumocephalus; pneumorrhachis; subdural hemorrhage