• Journal of Veterinary Clinics
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• v.41 no.4
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• pp.223-227
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• 2024

Air accumulation in the cranial cavity is referred to as pneumocephalus. Tension pneumocephalus is a neurosurgical emergency that can cause headaches, seizures, reduced consciousness, and even death owing to increased intracranial pressure. We report a case of tension pneumocephalus. The patient underwent a frontal sinusotomy for a mass invading the frontal sinus and nasal cavity. One month later, the patient was admitted to the emergency room with seizures and neurotic symptoms, and computed tomography (CT) revealed tension pneumocephalus with significant gas dilatation of both lateral ventricles. Prompt treatment of the dural defect resulted in the immediate improvement of neurological signs. A CT re-examination 1 week after surgery showed that the pneumocephalus had completely resolved. Tension pneumocephalus should be considered a potential complication in patients with worsening neurological signs after skull base surgery. An accurate diagnosis requires an understanding of imaging features and a high index of suspicion, and immediate intervention is essential.

• Archives of Craniofacial Surgery
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• v.17 no.4
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• pp.225-228
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• 2016

The entrapment of intracranial air from the check valve system results in a tension pneumocephalus. It should be distinguished from simple pneumocephalus because they are intracranial space-occupying masses that can threaten life. Communicating hydrocephalus is a serious and frequent complication of post-traumatic head injury. Head injury is one of the most common causes in etiopathogenesis of communicating hydrocephalus. Here, we describe a case of a 65-year-old man who developed communicating hydrocephalus after a post-traumatic tension pneumocephalus. To the best of our knowledge, this is the first reported case of communicating hydrocephalus developed after a post-traumatic tension pneumocephalus. Although the exact pathogenic mechanisms underlying the cascade following trauma remain unclear, communicating hydrocephalus after a tension pneumocephalus could be considered a possible complication.

• Journal of Korean Neurosurgical Society
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• v.47 no.5
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• pp.395-398
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• 2010

The majority of cases of pneumocephalus are secondary to trauma or medical intervention. Spontaneous, non-traumatic pneumocephalus is an uncommon condition. Most cases of spontaneous pneumocephalus require surgery. However, if there is no evidence of infection or cerebrospinal fluid leak, bed rest and follow-up imaging is an alternative treatment. Herein, we report a 31-year-old man with spontaneous pneumocephalus associated with pneumosinus dilatans.

• Journal of Korean Neurosurgical Society
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• v.53 no.4
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• pp.249-251
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• 2013

Pneumocephalus is a condition characterized by the presence of air in the cranium, and it is mainly caused by trauma or a neurosurgical procedure. In the absence of head trauma or a neurosurgical procedure, meningitis is an extremely rare cause of pneumocephalus. Here, the authors present a rare case of spontaneous pneumocephalus caused by pneumococcal meningitis, in which simple lateral radiography and computed tomography (CT) findings of the skull suggested the diagnosis. Cerebrospinal fluid analysis showed bacterial meningitis which later revealed streptococcus pneumonia. The patient was treated with antibiotics and responded remarkably well. Repeat CT performed after 2 weeks of treatment showed complete resolution of the intracranial gas. Here, the authors report an unusual case of a pneumocephalus caused by meningitis in the absence of head trauma or a neurosurgical procedure.

• Journal of Korean Neurosurgical Society
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• v.41 no.1
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• pp.47-49
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• 2007

The authors describe a rare case of tension pneumocephalus, caused by ventriculoperitoneal[V-P] shunting for communicating hydrocephalus. The patient had a history of a right frontal skull fracture and pneumocephalus after a traffic accident five months prior to the present presentation of gait disturbance and memory impairment. A CT scan showed hydrocephalus and a V-P shunt was put in place. On the fourth day after surgery, the mental status of the patient gradually deteriorated due to a tension pneumocephalus; this was treated by repairing a fistula in the frontal sinus and a dural defect. The patient's mental status improved and symptoms were completely recovered. We report a case of tension pneumocephalus following V-P shunt for hydrocephalus in a patient who sustained a right frontal skull fracture.

• Journal of Korean Neurosurgical Society
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• v.45 no.5
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• pp.318-321
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• 2009

Tension pneumocephalus may follow a cerebrospinal fluid(CSF) leak communicating with extensive extradural air. However, it rarely occurs after diagnostic lumbar puncture, and its treatment and pathophysiology are uncertain. Tension pneumocephalus can develop even after diagnostic lumbar puncture in a special condition. This extremely rare condition and underlying pathophysiology will be presented and discussed. The authors report the case of a 44-year-old man with a basal skull fracture accompanied by pneumothorax necessitating chest tube suction drainage, who underwent an uneventful lumbar tapping that was complicated by postprocedural tension pneumocephalus resulting in an altered mental status. The patient was managed by burr hole trephination and saline infusion following chest tube disengagement. He recovered well with no neurologic deficits after the operation, and a follow-up computed tomography (CT) scan demonstrated that the pneumocephalus had completely resolved. Tension pneumocephalus is a rare but serious complication of lumbar puncture in patients with basal skull fractures accompanied by pneumothorax, which requires continuous chest tube drainage. Thus, when there is a need for lumbar tapping in these patients, it should be performed after the negative pressure is disengaged.

• Journal of Korean Neurosurgical Society
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• v.37 no.4
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• pp.307-309
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• 2005

We report a rare case of tension pneumocephalus after eyebrow surgery for the treatment of a saccular aneurysm at posterior communicating artery. The patient's consciousness was suddenly aggravated due to the tension pneumocephalus on fifth postoperative day, which was treated by repairing the frontal sinus. The patient was recovered completely and uneventfully after this revision surgery.

• Journal of Korean Neurosurgical Society
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• v.37 no.1
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• pp.59-62
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• 2005

We describe two cases of tension pneumocephalus, one caused by ventriculoperitoneal shunt for communicating hydrocephalus, and the other caused by craniocerebral trauma. In the first case report, we examined the relationship between cerebrospinal fluid leakage and delayed onset tension pneumocephalus. The second case report, we addressed issues such as the diagnosis, management, and pathogenesis, as well as computerized tomography(CT) findings.

• The Korean Journal of Pain
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• v.25 no.4
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• pp.262-266
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• 2012

Several complications are possible after a lumbar epidural block. However pneumocephalus are rare. In this case, we report a case of pneumocephalus. A 68-year-old male patient received lumbar epidural block with the loss of resistance technique using air, and after 35 minutes, apnea, unconsciousness, hypotension, and bradycardia occurred. Immediately, brain CT was done, and we found pneumocephalus. The patient complained of severe occipital headache and itchiness due to pneumocehalus. After conservative treatment, the patient recovered without neurologic complications, and on the seventh day of his hospitalization, he was discharged from the hospital.

• Journal of Korean Neurosurgical Society
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• v.30 no.1
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• pp.81-84
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• 2001

Pneumocephalus is exceedingly rare in the absence of trauma or recent surgery. It is most commonly seen after severe head injury, with disruption of the dura and subsequent cerebrospinal fluid leakage. Intracranial air has also been reported as a complication of shunting. This may be secondary to intermittent shunt failure or a persistent communication between the extracranial and intracranial space that permits the entrance of air. In the present case, air appeared to enter the ventricular system through the fistula that connected the frontal sinus. This air replaced the CSF being drained into the peritoneal cavity by the shunt. The decrease of intracranial pressure after a shunt might play a role in causing pneumocephalus. We report a case of tension pneumocephalus after shunting for hydrocephalus as a life-threatning complication.