Pneumocephalus after lumbar epidural catheter: a case report

Abstract

Various complications have been associated with epidural block; pneumocephalus is one of the rare complications.
We report a case of pneumocephalus following epidural catheter placement in a 58 years old female patient referred
to our pain clinic for pain hypogastrium. After careful history and physical examination the diagnosis of neuropathic
pain was established. The pain did not relieve with the pharmacological treatment, so superior hypogastric ganglion
block was performed. The patient remained pain free for a week, after which the complaints recurred. Then an epidural
catheter was attempted twice but abandoned after two failed attempts. The catheter perforated the dura mater leading
to flow of CSF. After a few hours the patient developed a complaint of severe headache. The patient was hospitalised
and intravenous NSAID’s were started. However, the headache did not relieve, so CT scan brain was ordered, which
determined the presence of pneumocephalus. The patient was offered symptomatic treatment and after a week was
discharged home without any complication.