RT Journal Article
SR Electronic
T1 Pneumocephalus associated with epidural and spinal anesthesia for labor
JF Neurology: Clinical Practice
FD Lippincott Williams & Wilkins
SP 376
OP 382
DO 10.1212/CPJ.0000000000000178
VO 5
IS 5
A1 Reddi, Sudama
A1 Honchar, Valentyna
A1 Robbins, Matthew S.
YR 2015
UL http://cp.neurology.org/content/5/5/376.abstract
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.