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The Journal of the Association of... Feb 2021
Topics: Humans; Pneumocephalus; Tomography, X-Ray Computed
PubMed: 33527816
DOI: No ID Found -
World Journal of Critical Care Medicine Dec 2023Pneumorrhachis (PR) is defined as presence of free air in the spinal canal. Traumatic PR is very rare, and its exact incidence and pathogenesis is unknown. A... (Review)
Review
Pneumorrhachis (PR) is defined as presence of free air in the spinal canal. Traumatic PR is very rare, and its exact incidence and pathogenesis is unknown. A comprehensive literature search was performed using the PubMed, Cochrane Library, Google Scholar and Scopus databases to identify articles relevant to traumatic PR published till January 2023. A total of 34 resources were selected for inclusion in this narrative review. Traumatic PR can be classified anatomically into epidural and intradural types. In the epidural type, air is present peripherally in the spinal canal and the patients are usually asymptomatic. In contrast, in intradural PR, air is seen centrally in the spinal canal and patients present with neurological symptoms, and it is a marker of severe trauma. It is frequently associated with traumatic pneumocephalus, skull fractures or thoracic spine fracture. Computed tomography (CT) is considered to be the diagnostic modality of choice. Epidural PR is self-limited and patients are generally managed conservatively. Patients with neurological symptoms or persistent air in spinal canal require further evaluation for a potential source of air leak, with a need for surgical intervention. Differentiation between epidural and intradural PR is important, because the latter is an indication of severe underlying injury. CT imaging of the entire spine must be performed to look for extension of air, as well as to identify concomitant skull, torso or spinal injuries Most patients are asymptomatic and are managed conservatively, but a few may develop neurological symptoms that need further evaluation and management.
PubMed: 38188452
DOI: 10.5492/wjccm.v12.i5.248 -
World Neurosurgery Apr 2023Tension pneumosella has been recognized as a very rare complication of pituitary transsphenoidal surgery. To the best of our knowledge, we report the second case of a...
Tension pneumosella has been recognized as a very rare complication of pituitary transsphenoidal surgery. To the best of our knowledge, we report the second case of a pituitary adenoma "pneumo-apoplexy", which is characterized by findings consistent with tension pneumosella in the context of apoplexy of a pituitary adenoma; although it is an extremely rare diagnosis, it should be considered in patients with compatible clinical and radiological findings, particularly with a previous history of transsphenoidal pituitary surgery.
Topics: Humans; Pituitary Neoplasms; Pituitary Apoplexy; Adenoma; Pituitary Gland
PubMed: 36682526
DOI: 10.1016/j.wneu.2023.01.052 -
Journal of Neurological Surgery. Part... Nov 2020Tension pneumocephalus is a treatable emergency that is usually caused by trauma or surgery. We present a rare case of spontaneous tension pneumocephalus. A 64-year-old...
Tension pneumocephalus is a treatable emergency that is usually caused by trauma or surgery. We present a rare case of spontaneous tension pneumocephalus. A 64-year-old woman presented with a severe aggravating headache. Computed tomography revealed a large air collection in the brain parenchyma of the right frontal lobe, both lateral ventricles, and the subarachnoid space. Emergent craniotomy was performed because her headache got progressively worse. We found that an abnormal bony protrusion connected the frontal sinus mucosa and the intraparenchymal pneumocephalus. After removal of the bony mass and repair of the defect, the patient immediately recovered and there was no recurrence.
Topics: Brain; Craniotomy; Female; Frontal Lobe; Frontal Sinus; Headache; Humans; Middle Aged; Neurosurgical Procedures; Pneumocephalus; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 32911547
DOI: 10.1055/s-0040-1713798 -
Neurology Feb 2021
Topics: Brain Neoplasms; Cerebrospinal Fluid Rhinorrhea; Glioma; Humans; Male; Middle Aged; Neurosurgical Procedures; Pneumocephalus; Postoperative Complications; Tinnitus
PubMed: 33109623
DOI: 10.1212/WNL.0000000000011126 -
Acute and Critical Care May 2023Collection of air in the cranial cavity is called pneumocephalus. Although simple pneumocephalus is a benign condition, accompanying increased intracranial pressure can...
Collection of air in the cranial cavity is called pneumocephalus. Although simple pneumocephalus is a benign condition, accompanying increased intracranial pressure can produce a life-threatening condition comparable to tension pneumothorax, which is termed tension pneumocephalus. We report a case of tension pneumocephalus after drainage of a cerebrospinal fluid hygroma. The tension pneumocephalus was treated with decompression craniotomy, but the patient later died due to the complications related to critical care. Traumatic brain injury and neurosurgical intervention are the most common causes of pneumocephalus. Pneumocephalus and tension pneumocephalus are neurosurgical emergencies, and anesthetics and intensive care management like the use of nitrous oxide during anesthesia and positive pressure ventilation have important implications in their development and progress. Clinically, patients can present with various nonspecific neurological manifestations that are indistinguishable from a those of a primary neurological condition. If the diagnosis is questionable, patients should be investigated using computed tomography of the brain. Immediate neurosurgical consultation with decompression is the treatment of choice.
PubMed: 35545242
DOI: 10.4266/acc.2021.01102 -
European Journal of Case Reports in... 2020A 44-year-old woman presented with headache and delirium. Brain tomography indicated pneumocephalus, while blood and cerebrospinal fluid cultures revealed . Despite...
UNLABELLED
A 44-year-old woman presented with headache and delirium. Brain tomography indicated pneumocephalus, while blood and cerebrospinal fluid cultures revealed . Despite antibiotic treatment and admission to the intensive care unit, the patient died 3 days later. Pneumocephalus in association with meningitis is very rare and may be caused by gas produced by microorganisms.
LEARNING POINTS
Non-traumatic pneumocephalus should raise the suspicion of meningitis and prompt suitable treatment.Previous pneumococcal saccharide conjugate vaccine administration does not exclude the possibility of serious pneumococcal infection.
PubMed: 32665931
DOI: 10.12890/2020_001677 -
Acta Medica Portuguesa Dec 2019
Topics: Aged; Cerebrospinal Fluid Leak; Humans; Male; Meningitis, Bacterial; Pneumocephalus; Tomography, X-Ray Computed
PubMed: 31851889
DOI: 10.20344/amp.11591 -
Surgical Neurology International 2022Pneumocephalus is the presence of air in the intracranial cavity secondary to communication with the extracranial compartment. It occurs spontaneously, after trauma, or...
BACKGROUND
Pneumocephalus is the presence of air in the intracranial cavity secondary to communication with the extracranial compartment. It occurs spontaneously, after trauma, or after a cranial surgery.
CASE DESCRIPTION
A 62-year-old female, a known case of diabetes mellitus, presented to our emergency department with a sudden thunderclap headache. She was diagnosed with subarachnoid hemorrhage secondary to ruptured anterior communicating artery aneurysm. Twenty days later, she developed pneumonia and subsequently had a cardiac arrest. She was revived after 26 min of cardiopulmonary resuscitation. She developed pneumothorax requiring a chest tube insertion. After the first trial, she developed a diffuse subcutaneous emphysema, and the chest tube was reinserted. Afterward, she became unresponsive with dilated pupils. A computed tomography (CT) scan of the brain showed a diffuse subcutaneous emphysema reaching up to the face with air around the ventriculoperitoneal shunt distal catheter and extending through the burr hole to the ventricles causing pneumocephalus. There was no evidence of skull base fractures on brain CT. Unfortunately, the patient did not recover and passed away 3 days later.
CONCLUSION
This report describes the presentation and radiological findings of an interesting case of pneumocephalus following iatrogenic diffuse subcutaneous emphysema. It aims to increase the emphasis on early anticipation of such rare complication after subcutaneous emphysema.
PubMed: 35855157
DOI: 10.25259/SNI_994_2021 -
Internal and Emergency Medicine Jun 2020
Topics: Accidental Falls; Craniocerebral Trauma; Diagnosis, Differential; Fatal Outcome; Foreign Bodies; Glasgow Coma Scale; Humans; Male; Pneumocephalus; Tomography, X-Ray Computed; Wounds, Penetrating; Young Adult
PubMed: 31893347
DOI: 10.1007/s11739-019-02262-6