• Logo
  • SBMUJournals

Pneumocephalus After Dural Puncture During Epidural Analgesia: A Case Report

Gholamreza Mohseni, Faranak Behnaz, Zahra Tahmasebi




Lumbar epidural anesthesia commonly used to control post-operation pain. The ‘loss-of- resistance’ to air technique (LORA) generally engaged in the appreciation of the epidural space. One of the rare but serious side effects of this technique is pneumocephalus. We report a case of sudden frontal and parietal headache after a dural puncture during the performance of epidural analgesia using the LOR to air technique.


Epidural analgesia; ‘loss-of- resistance’ to air technique (LORA); Pneumocephalus; loss of consciousness; headache.


-Lim HY, Choi JW, Lee AR, Park HW, Choi DH. Pneumocephalus during labor analgesia using the combined spinal-epidural technique. Korean journal of anesthesiology. 2013 Dec;65(6 Suppl):S93.

-Wankar A, Maheshwari A, Athale S. Post epidural puncture delirium resulting from pneumocephalus: An uncommon presenation. Journal of Neuroanaesthesiology and Critical Care. 2016 Jan;3(01):043-5.

- Nistal-Nuño B, Gómez-Ríos MÁ. Case Report: Pneumocephalus after labor epidural anesthesia. F1000Research. 2014;3

-Nafiu OO, Urquhart JC. Pneumocephalus with headache complicating labour epidural analgesia: should we still be using air? International journal of obstetric anesthesia. 2006 Jul 1;15(3):237-9

-Kim YD, Lee JH, Cheong YK. Pneumocephalus in a patient with no cerebrospinal fluid leakage after lumbar epidural block-a case report. The Korean journal of pain. 2012 Oct;25(4):262

- Verdun AV, Cohen SP, Williams BS, Hurley RW. Pneumocephalus after lumbar epidural steroid injection: a case report and review of the literature. A&A Practice. 2014 Jul 1;3(1):9-13.

- Guarino AH, Wright NM. Pneumocephalus after a lumbar epidural steroid injection. Pain physician. 2005 Apr;8(2):239-41.

- Beilin Y, Arnold I, Telfeyan C, Bernstein HH, Hossain S. Quality of analgesia when air versus saline is used for identification of the epidural space in the parturient. Regional anesthesia and pain medicine. 2000 Nov 1;25(6):596-9.


  • There are currently no refbacks.

Comments on this article

View all comments