Pneumocephalous: Radiological Presentation of Intra-cranial Hypotension after Spinal Anaesthesia
Isra Khan *
Department of Radio-Diagnosis, JNMCH, Aligarh Muslim University, India.
Emad Alvi
Department of Surgery, JNMCH, Aligarh Muslim University, India.
Saifullah Khalid
Department of Radio-Diagnosis, JNMCH, Aligarh Muslim University, India.
Sameera Khanam
Department of Obstetrics and Gynaecology, RML Hospital of Medical Sciences, Lucknow, India.
Saad Mohammad
Department of Orthopaedics, Integral University of Health Sciences, Lucknow, India.
Mohammad Nasim Khan
Department of Paediatrics, Faculty of Medicine, Umm Al Qura University, Makkah, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Pneumocephalus is a commonly encountered entity in patients of head trauma and post-op cases of neurosurgery, however it is rarely observed after spinal anaesthesia.
It commonly presents orthostatic hypotension associated with severe headache, nausea and vomiting. We report a case of pneumocephalus following spinal anaesthesia administered for open hernia repair.
The proposed mechanisms of pneumocephalus secondary to spinal tapping are the ball-valve mechanism (1) and the inverted soda-bottle effect (2).
Keywords: Pneumocephalus, intracranial hypotension, thunderclap headache, post-operative, spinal anaesthesia, complication