Intramedullary air in the high cervical spinal cord after cervical epidural steroid injection

Abstract

Cervical epidural steroid injection is accepted as one of several approaches to treat pain in the neck and upper extremities after traumatic nerve root irritation. We describe a case of intramedullary air in the high cervical spinal cord after cervical epidural steroid injection and discuss a possible etiology. A 16 year old female underwent cervical epidural steroid injection for cervical radiculopathy. Two days after the injection she presented with numbness and tingling in her upper and lower extremities. CT scan revealed an air bubble at the C2 level. Management included dexamethasone, gabapentin, and hyperbaric oxygen therapy. The air bubble dissipated and the patient's symptoms resolved.