A case of pneumocephalus during labor epidural analgesia: A case report

ABSTRACT

Pneumocephalus can be developed after a dural puncture, which occurs in association with epidural procedures. A 37-year-old, gestational age 40 weeks, pregnant woman was admitted for vaginal delivery. She asked for epidural analgesia when she suffers with labor pain. Epidural anesthesia was done at the L3-L4 interspace with the loss of resistance technique, using air. During the identification of the epidural space, an accidental dural puncture was diagnosed by observing a free flow of CSF, through the needle. The patient developed headache 2 hours later. She was treated with hydration, oxygen, analgesics and the autologus blood patch procedure was done, at the L4-L5 interspace. Despite these measures, the patient's symptoms worsened with nausea and vomiting. A brain CT scan showed the presence of pneumocephalus. After 100% oxygen therapy and metoclopramide injection, she was discharged on postpartum 2 days, without any complications.