title: Delayed Pneumocephalus Following Fluoroscopy Guided Cervical Interlaminar Epidural Steroid Injection: A Rare Complication and Anatomical Considerations.
abstract: Cervical epidural steroid injection is indicated for radicular symptoms with or without axial neck pain. Complications are rare but can be serious. Here, we report the case of a 54-year-old man with cervical radicular pain who was treated with cervical epidural steroid injection. Injection was administered twice under fluoroscopic guidance with the loss-of-resistance technique using air to confirm the epidural space. After the second procedure, the patient complained of severe persistent headache and was diagnosed with pneumocephalus on brain computed tomography. The patient returned home without any neurological complication, after a few days of conservative treatment. Though, a fluoroscopic guidance cervical epidural injection is also known to diminish the risk of complications. Physicians should always keep in mind that it does not guarantee safety, particularly in the cervical region, related to its anatomical considerations.
authors.affiliation: Department of Anesthesiology and Pain Medicine, School of Medicine, Wonkwang University Hospital, Iksan, Korea. ; Institute of Wonkwang Medical Science, Iksan, Korea.
authors.forename: Yeon-Dong
authors.initials: YD
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, School of Medicine, Wonkwang University Hospital, Iksan, Korea.
authors.forename: Hyang-Do
authors.initials: HD
authors.lastname: Ham
authors.affiliation: Department of Pain Medicine, MHS Interventional Treatment Center, Gwangju, Korea.
authors.forename: Hyun-Seog
authors.initials: HS
authors.lastname: Moon
authors.affiliation: Department of Neurosurgery, Chonnam National University Hospital and Medical School, Gwangju, Korea.
authors.forename: Soo-Han
authors.initials: SH
authors.lastname: Kim
keywords: Cervical epidural steroid injection; Complication; Pneumocephalus