Background: Epidural analgesia is a widely used technique for pain relief especially during labor. Headache complaint, is rare after epidural block with the loss of resistance to air/saline technique, is frequent after dural puncture and pneumocephalus and is attributed to intracranial meningeal irritation after air injection in the intrathecal or subdural space with a consequent cephalic dispersion.
Case presentation: 28-year-old female pregnant lady provided epidural analgesia for labor pain. 3 days following epidural she presented with postdural puncture headache. Her headache was treated by epidural blood patch complicated with pneumocephalus showed by brain and spine MRI.
Conclusion: Such complication could be avoided if punctures following dural puncture used saline. Our case confirms the possibility of iatrogenic pneumocephalus during epidural block with the loss of resistance to air technique for epidural space identification. Signs and symptoms of meningeal irritation, CT/MRI is the diagnostic tool recommended for the differential diagnosis of pneumocephalus