Epidural Granuloma and Intracranial Hypotension Resulting from Cervical Epidural Steroid Injection

CERVICAL epidural steroid injections (CESIs) are generally used for the treatment of radiculopathy and pain. Other reasons cited for using CESIs include postlaminectomy syndrome, bulging cervical disc, and brachial plexitis. 1 Side effects of CESIs include stiff neck, flushing, wet tap, failed block, vomiting, upper extremity motor weakness, and transient paresthesia. 1-2 Rare but potentially catastrophic complications of CESI can occur, such as arachnoiditis, hematoma, meningitis, and quadraplegia. 3,4 We present a case of cervical epidural granuloma and intracranial hypotension after administration of epidural triamcinolone acetonide (Kenalog; Bristol-Myers Squibb, Princeton, NJ).