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Category: Volume 07 Issue 10 October 2019
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Title: Pneumocephalus after Epidural Injection of Steroid: A Rare Case Report

Authors: Dr K. Sai Lavanya, Dr Shiny Priyadarshini, Dr Krishna Chaitanya,  Dr Mushahida, Dr Shashank Mudhelli

 DOI: https://dx.doi.org/10.18535/jmscr/v7i10.127

Abstract

   

Lumbar epidural steroid injections are commonly performed for the treatment of low back and lower extremity radicular pain. A patient aged 53 years with L4-L5 spondylosis with radiculopathy was given lumbar epidural steroid injection using loss of resistance to air technique with 3 ml of air.  2hrs later, she developed severe headache with an episode of non-projectile vomiting, followed by irritability, breathlessness, unconsciousness. Patient was resuscitated immediately and shifted to ICU for further management. An MRI was done which revealed pneumocephalus and patient was treated symptomatically and discharged after complete recovery after 3 days from the hospital. We conclude that the amount of air used to confirm LORA should be minimised and the use of saline avoids such complications. 

Keywords-epidural anaesthesia, spondylosis, pneumocephalus.

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Corresponding Author

Dr Krishna Chaitanya