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[General convulsive crisis related to pneumocephalus after inadvertant dural puncture in an obstetric patient]
P Rodrigo1, J M García, J Ailagas
1Servicio de Anestesiología, Hospital de Basurto, Bilbao.
We report a case of iatrogenic pneumocephalus in an obstetric patient after accidental dural puncture during repeated attempts to locate the epidural space by the technique of loss-of-resistance to air. Analgesia was provided throughout labor. Two days after puncture, typical spinal headache developed and was treated with bed rest, oral analgesics and hydration. The patient was released four days after delivery but returned to the hospital emergency service after suffering general convulsions and loss of consciousness which resolved spontaneously. A computerized tomography (CT) scan revealed pneumocephalus, to which the convulsions were attributed. No further convulsions occurred in spite of the fact that anticonvulsives were not prescribed. A CT scan one month later was normal.
We report a case of iatrogenic pneumocephalus in an obstetric patient after accidental dural puncture during repeated attempts to locate the epidural space by the technique of loss-of-resistance to air. Analgesia was provided throughout labor. Two days after puncture, typical spinal headache developed and was treated with bed rest, oral analgesics and hydration. The patient was released four days after delivery but returned to the hospital emergency service after suffering general convulsions and loss of consciousness which resolved spontaneously. A computerized tomography (CT) scan revealed pneumocephalus, to which the convulsions were attributed. No further convulsions occurred in spite of the fact that anticonvulsives were not prescribed. A CT scan one month later was normal.