PT  - JOURNAL ARTICLE
AU  - Reddi, Sudama
AU  - Honchar, Valentyna
AU  - Robbins, Matthew S.
TI  - Pneumocephalus associated with epidural and spinal anesthesia for labor
AID  - 10.1212/CPJ.0000000000000178
DP  - 2015 Oct 01
TA  - Neurology: Clinical Practice
PG  - 376--382
VI  - 5
IP  - 5
4099  - http://cp.neurology.org/content/5/5/376.short
4100  - http://cp.neurology.org/content/5/5/376.full
AB  - Headache resulting from dural puncture in epidural and spinal anesthesia is usually secondary to a CSF leak. Pneumocephalus may also occur in this setting but has not been well-characterized. Although the risk factors for a CSF leak and pneumocephalus may overlap, their rates, clinical features, and treatments may be different. Our retrospective review of 182 patients with acute headache in the antepartum, peripartum, and postpartum settings yielded a 5:1 ratio of postdural puncture headache to pneumocephalus. The 3 patients with pneumocephalus had the defining characteristic of thunderclap headache during anesthesia. Early diagnosis is helpful as treatment with supplemental oxygen may hasten recovery. Pneumocephalus should be considered as a possible etiology of thunderclap headache in the setting of epidural and spinal anesthesia.