Subarachnoid cisterns pneumocephalus

Case contributed by Naim Qaqish
Diagnosis almost certain

Presentation

Severe headache three days postpartum.

Patient Data

Age: 40 years
Gender: Female

Brain

ct

No acute intracranial hemorrhage.

Multiple gas bubbles are seen in the frontal and occipital horns of the right lateral ventricle, in the interpeduncular cistern, and in the cavernous sinuses.

Normal size and position of the ventricular system. 

No shift of midline structures.

No evidence of space-occupying mass lesions or any other focal brain pathology.

Case Discussion

This case illustrates a rare complication of epidural anesthesia in three days postpartum lady presenting with severe headache through ER. Brain CT was requested by the treating team, to rule out hemorrhage and revealed multiple air bubbles in the subarachnoid cisterns which is better detected using lung window.

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