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Headache from Intracranial Air after a Lumbar Epidural Injection:: Subarachnoid or Subdural?
  1. Quinn H. Hogan, M.D.* and
  2. David J. Haddox, D.S.S., M.D.**
  1. *From the Departments of Anesthesiology, Medical College of Wisconsin, Milwaukee, and
  2. **Emory University School of Medicine, Atlanta, Georgia.
  1. Address reprint requests to Quinn H. Hogan, M.D., Department of Anesthesiology, Milwaukee County Medical Complex. 8700 W. Wisconsin Ave., Milwaukee, WI 53226.


Background and methods. There is a growing awareness of the possibility of headache resulting from intracranial air secondary to identification of the epidural space by loss of resistance using air (LOR-A). Most reported cases have been attributed to subarachnoid air passage. A case is described of sudden headache following LOR-A.

Results. Various features of the case suggest that the passage of air to the head was subdural rather than subarachnoid.

Conclusions. Recovery was uneventful.

  • Complications
  • epidural anesthesia
  • headache
  • subdural space.

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  • The authors thank Victor Haughton, M.D., Roy Strand, M.D., Juan Taveras, M.D., and Alan Williams, M.D. for evaluation of the x-ray images.