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Pneumocephalus following an epidural blood patch
T Kawamata1, K Omote, M Matsumoto
1Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan. kawamata@sapmed.ac.jp
Acta Anaesthesiologica Scandinavica
|July 16, 2003
Summary
Pneumocephalus, a rare complication of epidural block, can occur even when the epidural needle is correctly placed. This case highlights a potential risk during epidural blood patch procedures following dural puncture.
Area of Science:
- Anesthesiology
- Neurosurgery
- Radiology
Background:
- Epidural block complications are uncommon but serious.
- Unintentional dural puncture can lead to cerebrospinal fluid leakage.
- Epidural blood patch is a common treatment for post-dural puncture headaches.
Observation:
- A patient developed pneumocephalus after an epidural blood patch.
- The procedure was performed 3 days post-unintentional dural puncture.
- The epidural needle was confirmed to be within the epidural space.
Findings:
- Pneumocephalus is a potential complication of epidural blood patch.
- Air can enter the epidural space during the procedure, even with correct needle placement.
- This can occur irrespective of the timing after the initial dural puncture.
Implications:
- Clinicians should be aware of pneumocephalus as a rare complication of epidural procedures.
- Careful technique during epidural blood patch may help mitigate risk.
- Further investigation into the mechanisms of air entry is warranted.