Abstract
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.
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References
A Hukuuchi K Yokoyama (1983) ArticleTitleCase of subdural pneumocephalus after epidural anesthesia Masui 32 1132–1135 Occurrence Handle6663702 Occurrence Handle1:STN:280:DyaL2c7hsFanug%3D%3D
KM Ash JE Cannon DR Biehl (1991) ArticleTitlePneumocephalus following attempted epidural anaesthesia Can J Anaesth 38 772–774 Occurrence Handle1914063 Occurrence Handle1:STN:280:DyaK38%2FgsF2qug%3D%3D Occurrence Handle10.1007/BF03008458
Y Katz R Markovits B Rosenberg (1990) ArticleTitlePneumocephalus after inadvertent intrathecal air injection during epidural block Anesthesiology 73 1277–1279 Occurrence Handle2248409 Occurrence Handle1:STN:280:DyaK3M%2FmtlKjuw%3D%3D Occurrence Handle10.1097/00000542-199012000-00034
FJ Gonzalez-Carrasco JL Aguilar C Llubia S Nogues F Vidal-Lopez (1993) ArticleTitlePneumoencephalus after accidental dural puncture during epidural anesthesia Reg Anesth 18 193–195 Occurrence Handle8323896 Occurrence Handle1:STN:280:DyaK3szht1OktQ%3D%3D
QH Hogam JD Haddox (1992) ArticleTitleHeadache after intracranial air after a lumbar epidural injection: subarachnoid or subdural? Reg Anesth 17 303–305
JM Kreitzer AP Reed AT Duaro ML Brodman DJ Bronster (1991) ArticleTitleAscending back pain and headache during attempted epidural placement J Clin Anesth 13 414–417 Occurrence Handle10.1016/0952-8180(91)90188-S
JA Katz R Lukin PO Bridenbaugh L Gunzenhauser (1991) ArticleTitleSubdural intracranial air: an unusual cause of headache after epidural steroid injection Anesthesiology 74 615–618 Occurrence Handle1825771 Occurrence Handle10.1097/00000542-199103000-00033 Occurrence Handle1:STN:280:DyaK3M7lvVWnuw%3D%3D
S Laviola M Kirvela MR Spoto S Tschuor E Alon (1999) ArticleTitlePneumocephalus with intense headache and unilateral pupillary dilatation after accidental dural puncture during epidural anesthesia for cesarean section Anesth Analg 88 582–583 Occurrence Handle10072010 Occurrence Handle10.1097/00000539-199903000-00022 Occurrence Handle1:STN:280:DyaK1M7ntVahtA%3D%3D
R McMurtrie SuffixJr R Jan (2002) ArticleTitleSubarachnoid pneumocephalus: a rare complication of epidural catheter placement J Clin Anesth 14 539–542 Occurrence Handle12477592 Occurrence Handle10.1016/S0952-8180(02)00426-9
Y Ishikawa K Fujitsu T Sekino H Fujino K Kubone T Kuwabara (1988) ArticleTitleSubdural tension pneumocephalus following surgery for chronic subdural hematoma J Neurosurg 68 58–61 Occurrence Handle10.3171/jns.1988.68.1.0058
B Ramamurthi (1976) Acute subdural hematoma PJ Vinken GW Bruyn (Eds) Handbook of clinical neurology. Vol. 24 North-Holland Publishing Amsterdam 276
T Lubenow E Keh-Wong K Kristof O Ivakovich AD Ivakovich (1988) ArticleTitleInadvertent subdural injection Anesth Analg 67 175–179 Occurrence Handle3341567 Occurrence Handle10.1213/00000539-198802000-00012 Occurrence Handle1:STN:280:DyaL1c7jtFykug%3D%3D
GP Kozkowski SP Cohen (2004) ArticleTitleLumbar puncture associated with pneumocephalus: report of a case Anesth Analg 98 524–526 Occurrence Handle10.1213/01.ANE.0000095153.75625.1F
HS Chadwick CM Bernards DW Kovarik JJ Tomlin (1992) ArticleTitleSubdural injection of morphine for analgesia following cesarean section: a report of three cases Anesthesiology 77 590–594 Occurrence Handle1519797 Occurrence Handle10.1097/00000542-199209000-00028 Occurrence Handle1:STN:280:DyaK38zptFOhsg%3D%3D
CM Bernards HF Hill (1990) ArticleTitleMorphine and alfentanil permeability through the spinal dura, arachnoid, and pia mater of dogs and monkeys Anesthesiology 73 1214–1219 Occurrence Handle2248398 Occurrence Handle10.1097/00000542-199012000-00020 Occurrence Handle1:CAS:528:DyaK3MXhtFCmt7c%3D
AA Arutru (1982) ArticleTitleNitrous oxide plays a direct role in development of tension pneumocephalus intraoperatively Anesthesiology 57 59–61 Occurrence Handle10.1097/00000542-198209001-00059
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Kasai, K., Osawa, M. Pneumocephalus during continuous epidural block. J Anesth 21, 59–61 (2007). https://doi.org/10.1007/s00540-006-0446-1
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DOI: https://doi.org/10.1007/s00540-006-0446-1