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Delayed Pneumocephalus Following Fluoroscopy Guided Cervical Interlaminar Epidural Steroid Injection : A Rare Complication and Anatomical Considerations

  • Kim, Yeon-Dong (Department of Anesthesiology and Pain Medicine, School of Medicine, Wonkwang University Hospital) ;
  • Ham, Hyang-Do (Department of Anesthesiology and Pain Medicine, School of Medicine, Wonkwang University Hospital) ;
  • Moon, Hyun-Seog (Department of Pain Medicine, MHS Interventional Treatment Center) ;
  • Kim, Soo-Han (Department of Neurosurgery, Chonnam National University Hospital and Medical School)
  • 투고 : 2014.07.16
  • 심사 : 2014.09.23
  • 발행 : 2015.05.28

초록

Cervical epidural steroid injection is indicated for radicular symptoms with or without axial neck pain. Complications are rare but can be serious. Here, we report the case of a 54-year-old man with cervical radicular pain who was treated with cervical epidural steroid injection. Injection was administered twice under fluoroscopic guidance with the loss-of-resistance technique using air to confirm the epidural space. After the second procedure, the patient complained of severe persistent headache and was diagnosed with pneumocephalus on brain computed tomography. The patient returned home without any neurological complication, after a few days of conservative treatment. Though, a fluoroscopic guidance cervical epidural injection is also known to diminish the risk of complications. Physicians should always keep in mind that it does not guarantee safety, particularly in the cervical region, related to its anatomical considerations.

키워드

참고문헌

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피인용 문헌

  1. Review of Medical Dispute Cases in the Pain Management in Korea: A Medical Malpractice Liability Insurance Database Study vol.28, pp.4, 2015, https://doi.org/10.3344/kjp.2015.28.4.254
  2. Incidence of Inadvertent Dural Puncture During CT Fluoroscopy–Guided Interlaminar Epidural Corticosteroid Injections in the Cervical Spine: An Analysis of 974 Cases vol.209, pp.3, 2017, https://doi.org/10.2214/ajr.16.17738
  3. Feasibility of Using the Epidural Space Detecting Device (EPI-Detection TM ) for Interlaminar Cervical Epidural Injection vol.9, pp.8, 2020, https://doi.org/10.3390/jcm9082355