Pneumocephalous: Radiological Presentation of Intra-cranial Hypotension after Spinal Anaesthesia

Abstract

Pneumocephalus is a commonly encountered entity in patients of head trauma and post-op cases of neurosurgery, however it is rarely observed after spinal anaesthesia.
 It commonly presents orthostatic hypotension associated with severe headache, nausea and vomiting. We report a case of pneumocephalus following spinal anaesthesia administered for open hernia repair.
 The proposed mechanisms of pneumocephalus secondary to spinal tapping are the ball-valve mechanism (1) and the inverted soda-bottle effect (2).