Minim Invasive Neurosurg 2000; 43(2): 98-101
DOI: 10.1055/s-2000-8326
ÜBERSICHT
Georg Thieme Verlag Stuttgart · New York

Subdural and Intraventricular Traumatic Tension Pneumocephalus: Case Report

E. Gönül, Y. .Izci, A. Sali, A. Baysefer, E. Timurkaynak
  • Department of Neurosurgery, School of Medicine GATA, Etlik-Ankara, Turkey
Further Information

Publication History

Publication Date:
31 December 2000 (online)

Simple pneumocephalus most frequently arises as a complication of a head injury in which a compound basal skull fracture with tearing of the meninges allows entry of air into the cranial cavity. It can also follow a neurosurgical operation. Tension traumatic pneumocephalus with intraventricular extension is an extremely rare, potentially lethal condition that requires prompt diagnosis and treatment. We report the case of subdural and intraventricular accidental tension pneumocephalus occurring in a 26-year-old man as a result of skull fracture. This case is combined with rhinorrhea and meningitis that suggest some difficulties to treat. The operative procedure associated with medical treatment was performed and a good result was obtained.

References

  • 1 Markham J W. The clinical features of pneumocephalus based upon a survey of 284 cases with report of 11 additional cases.  Acta Neuchir (Wien). 1967;  16 1-78
  • 2 Davis D H, Laws E R, McDonald T J, Salasa J R, Philips L H. Intraventricular tension pneumocephalus as a complication of paranasal sinus surgery: case report.  Neurosurgery. 1981;  8 574-576
  • 3 Myelonas C. Delayed pneumocephalus in patients with CSF shunts.  Brit J Neurosurg. 1991;  5 67-72
  • 4 Bremer A M, Nguyen T Q. Tension pneumocephalus after surgical treatment of chronic subdural hematoma: report of three cases.  Neurosurgery. 1982;  11 284-287
  • 5 Haran R P, Mathew J C. Symptomatic pneumocephalus after transsphenoidal surgery.  Surg Neurol. 1997;  48 575-578
  • 6 Altlnörs N, Arda N, Karset Z. Tension pneumocephalus after transsphenoidal surgery: case report.  Neurosurgery. 1988;  23 516-518
  • 7 Cadrina R, Galli G, Bollati A. Letter to the editor: subdural and intraventricular tension pneumocephalus after transsphenoidal operation.  J Neurol Neurosurg Psychiatry. 1988;  51 1005
  • 8 Shields C B, Valdes-Rodriguez A G. Tension pneumocephalus after transsphenoidal hypophysectomy: case report.  Neurosurgery. 1982;  11 687-689
  • 9 Wohlgemuth M V. Tension pneumocephalus.  J Neurosurg Nurs. 1985;  17 146-154
  • 10 Langfitt T W. Increased intracranial pressure.  Clin Neurosurg. 1969;  16 436-471
  • 11 Saidman L J, Eger E R. Change in cerebrospinal fluid pressure during pneumocephalography under nitrous oxide anesthesia.  Anesthesiology. 1965;  26 67-72
  • 12 Shapiro H M. Intracranial hypertension: Therapeutic and anesthetic considerations.  Anesthesiology. 1975;  43 445-470
  • 13 Baker M A. Postoperative tension pneumocephalus. Report of 2 cases and typical computed tomographic findings.  J Osteopath Assoc. 1986;  86 285-288
  • 14 Caron J L, Worthington C, Bertrand G. Tension pneumocephalus after evacuation of chronic subdural hematoma and subsequent treatment with continuous lumbar subarachnoid infusion and craniostomy drainage.  Neurosurgery. 1985;  16 107-110
  • 15 Kitahata L M, Katz J D. Tension pneumocephalus after posterior-fossa craniotomy, a complication of the sitting position.  Anesthesiology. 1976;  44 448-450
  • 16 Monajati A, Contach W W. Subdural tension pneumocephalus following surgery.  J Comput Assist Tomogr. 1982;  6 902-906
  • 17 Pandit U A, Mudge D J, Keller T S. Pneumocephalus after posterior fossa exploration in the sitting position.  Anesthesia. 1982;  37 996-1001
  • 18 Lunsford L D, Maroon J C, Sheptak P E. Subdural tension pneumocephalus. Report of 2 cases.  J Neurosurg. 1979;  50 525-527
  • 19 Walker F O, Vern B A. The mechanisms of pneumocephalus formation in patients with CSF fistulas.  J Neurol Neurosurg Psychiatry. 1986;  49 203-205
  • 20 Osborn A G, Daines J H, Wing S D. Intracranial air on computerized tomography.  J Neurosurg. 1978;  48 355-359
  • 21 Horwitz N H, Rizzoli H V. Postoperative complications of intracranial neurological surgery. Baltimore: Williams and Wilkins 1982
  • 22 Horton D D, Pollay M, Reynolds jr A F. Intraventricular pneumocephalus secondary to subcutaneous emphysema: A case report.  Neurosurgery. 1984;  15 557-558
  • 23 Ram Z, Knoller N, Findler G, Sahar A. Delayed intraventricular tension pneumocephalus complicating posterior fossa surgery for cerebellar medulloblastoma.  Child's Nerv Sys. 1992;  8 351-353
  • 24 Huang C F, Chou T Y, Chang C K. Traumatic tension pneumocephalus-intracerebral pneumatocele: A case report.  Kao Hsiung I Hsueh Tsa Chih. 1992;  8 113-116
  • 25 Arbit E, Shah J, Bedford R, Carlon G. Tension pneumocephalus: treatment with controlled decompression via a closed water-seal drainage system: case report.  J Neurosurg. 1991;  74 139-142
  • 26 Tanaka A, Matsumoto N, Fukushima T, Tomonaga M. Spontaneous intracerebral pneumocephalus after ventriculoperitoneal shunting in patients with posterior fossa tumors. Report of 2 cases.  Neurosurgery. 1986;  18 499-501
  • 27 Ruge J R, Cerullo L J, McLone D G. Pneumocephalus in patients with CSF shunts.  J Neurosurg. 1985;  63 532-536
  • 28 Squali J, Amar Y, Fikri K, Lazreq C, Sbihi A. La pneumocéphalie: un indice prognostique chez le traumatisé cranien.  Cah Anesthesiol. 1996;  44 285-288

Corresponding Author:

E Gönül,M. D 

Department of Neurosurgery School of Medicine GATA Etlik-Ankara

Turkey

Phone: Phone:+90 312 321 03 70

Fax: Fax:+90 312 321 23 99