A Symptomatic Pneumocephalus as a Complication of Lumbar Epidural Anaesthesia

Authors

• Ana Filipa Pires Serviço de Medicina Interna, Hospital Padre Américo, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
• Teresa Martins Mendes Serviço de Medicina Interna, Hospital Padre Américo, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
• Ana Areia Reis Serviço de Medicina Interna, Hospital Padre Américo, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
• Ana Ferreira Pacheco Serviço de Medicina Interna, Hospital Padre Américo, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
• Vítor Fagundes Serviço de Medicina Interna, Hospital Padre Américo, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
• Mari Mesquita Serviço de Medicina Interna, Hospital Padre Américo, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal

anafilipa.pir@gmail.com

Keywords

Abstract

Introduction: Lumbar epidural anaesthesia is a commonly used technique for analgesia during labour. One of the rare complications of this technique is pneumocephalus.
Case description: We report the case of a 35-year-old female admitted to the Emergency Department with severe headache associated with fast head movements. Five days previously she had a eutocic delivery and lumbar epidural anaesthesia was performed. A brain computed tomography (CT) scan showed pneumocephalus and she was admitted to the hospital ward. A brain CT scan on the fourth day of hospitalization showed resolution of ventricular pneumocephalus.
Discussion: The most frequently occurring symptom with pneumocephalus is headache associated with fast brain motion resulting from air injection and meningeal irritation. When there is clinical suspicion of pneumocephalus, a brain CT scan should be performed for the diagnosis.