Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Case Report

Hyperbaric oxygen therapy in the treatment of pneumocephalus associated with epidural block - case report

A oxigenoterapia hiperbárica no tratamento de pneumocéfalo associado a bloqueio epidural: caso clínico

João Castedo, António Pedro Ferreira, Óscar Camacho

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Pneumocephalus is a rare neuraxial blockade complication, which can be associated with severe neurologic changes.

Clinical case
A 51-year-old patient was submitted to left total knee arthroplasty. Postoperatively, a pneumocephalus associated with decreased consciousness was diagnosed as a complication of the epidural analgesia. The treatment used was Hyperbaric Oxygen Therapy (HBOT) due to the severity of symptoms. Just after one session of HBOT, there was nearly full pneumocephalus resorption and significant clinical recovery.

This case report enables anesthesiologists to recognize HBOT as a therapeutic option to be considered when treating severe cases of pneumocephalus.


Epidural analgesia,  Pneumocephalus,  Hyperbaric oxygen therapy,  Clinical case


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2 J. Chacko, K. Levis, B. Hahn Pneumocephalus after Epidural Injection J Emerg Med, 54 (2018), pp. e45-7

3 J.M. Jones, J.P. Gouveia, N.M. Rodrigues Pneumocephalus and seizures following combined spinal-epidural for labor J Clin Anesth, 44 (2018), pp. 123-124

4 C.-C. Shih, S.-H. Tsai, W.-I. Liao, J.-C. Wang, C.-W. Hsu Successful treatment of epidural anesthesia-induced severe pneumocephalus by hyperbaric oxygen therapy Am J Emerg Med, 33 (2015) 1116.e1–1116.e3

5 RE Moon Hyperbaric oxygen treatment for decompression sickness Undersea Hyperb Med, 41 (2014), pp. 151-157

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