Pneumocephalus after lumbar epidural catheter: A case report

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.