A Symptomatic Pneumocephalus as a Complication of Lumbar Epidural Anaesthesia

Introduction: Lumbar epidural anaesthesia is a commonly used technique for analgesia during labour. One of the rare complications of this technique is pneumocephalus. Case description: We report the case of a 35-year-old female admitted to the Emergency Department with severe headache associated with fast head movements. Five days previously she had a eutocic delivery and lumbar epidural anaesthesia was performed. A brain computed tomography (CT) scan showed pneumocephalus and she was admitted to the hospital ward. A brain CT scan on the fourth day of hospitalization showed resolution of ventricular pneumocephalus. Discussion: The most frequently occurring symptom with pneumocephalus is headache associated with fast brain motion resulting from air injection and meningeal irritation. When there is clinical suspicion of pneumocephalus, a brain CT scan should be performed for the diagnosis.

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The utility of brain CT scan modality in the management of dizziness at the emergency department: A retrospective single-center study

Annals of Medicine and Surgery ◽

10.1016/j.amsu.2021.102220 ◽

2021 ◽

pp. 102220

Author(s):

Khaled Z. Alawneh ◽

Liqaa A. Raffee ◽

Ahmad A. Oqlat ◽

Ammar A. Oglat ◽

Majdi Al Qawasmeh ◽

...

Keyword(s):

Emergency Department ◽

Ct Scan ◽

Single Center ◽

Brain Ct ◽

Single Center Study ◽

Brain Ct Scan ◽

Center Study

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The Relationship between Risk Factors of Head Trauma with CT Scan Findings in Children with Minor Head Trauma Admitted to Hospital

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2017.071 ◽

2017 ◽

Vol 5 (3) ◽

pp. 319-323 ◽

Cited By ~ 2

Author(s):

Babak Masoumi ◽

Farhad Heydari ◽

Hamidreza Hatamabadi ◽

Reza Azizkhani ◽

Zahra Yoosefian ◽

...

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Ct Scan ◽

Head Trauma ◽

Predictive Value ◽

Tissue Injury ◽

Soft Tissue Injury ◽

Normal Brain ◽

Brain Ct ◽

Brain Ct Scan

BACKGROUND: In emergency medicine for determining the intracranial injury (ICI) in children with head trauma, usually brain CT scan is performed. Since brain CT scan, especially in children, has some disadvantages, it is better to find a procedure which could help to choose only the children with real head trauma injury for brain CT scan.AIMS: The aim of this study is to find such procedure. This study was descriptive, analytic and non-interventional.METHODS: We reviewed the archived files of children with head trauma injuries referred to the emergency department of Imam Hossein Hospital within two years. Patientâ€™s CT scan findings and head trauma risk factors were evaluated in this study.RESULTS: Out of 368 patients, 326 patients had normal brain CT scan. 28 of them showed symptoms of ICI consisting intraventricular haemorrhage (IVH), contusion, subarachnoid haemorrhage (SAH), subdural haemorrhage (SDH), epidural hematoma (EDH), and pneumocephalus. Twenty-seven patients showed skull FX, which 14 of them had an Isolated fracture, and 13 of them also showed symptoms of ICI. Since patients with isolated FX usually discharge quickly from Emergency Department; their data did not include in results of the study. The patients have been divided into two groups: 1- ICI, 2- without ICI. RR (relative risk), CI (Confidence interval) and sensitivity, positive predictive value (PPV), negative predictive value (NPV) and association of these risk factors with ICI were assessed with the Chi-2 test. In the end to determine the indications of CT scan, the presence of one of these five risk factors is important including abnormal mental status, clinical symptoms of skull FX, history of vomiting, craniofacial soft tissue injury (including subgaleal hematomas or laceration) and headache.CONCLUSIONS: For all other patients without these risk factors, observation and Follow Up can be used which has more advantages and less cost.

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