ABSTRACT
Pneumocephalus is a well known complication of spinal and epidural anesthesia, but subclinical pneumocephalus complicated by fever leading to intracranial mass effect (tension pneumocephalus) is extremely rare. We report a case of sudden and progressive bifrontal headache and confusion after a dural puncture during the procedure of epidural anesthesia. The pneumocephalus resolved spontaneously after 5 days. Possible mechanisms for this occurrence, along with steps that can be taken to prevent this complication, are discussed.