Delayed spontaneous pneumocephalus in ventriculoperitoneal shunting: Two case reports and literature review

Aguilar, Edinson Najera; Ramírez, María C Gómez; Zabala, A. Bollar; Bareño, Enrique Úrculo

doi:10.1016/j.neucir.2013.05.001

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…[11][12][13][14] The first mechanism is the presence of a promoting factor drawing air into the intracranial space by decreasing the CSF pressure, such as a VP shunt or CSF leakage. [4][5][6][7][8][9] The second mechanism is a one-way valve mechanism that permits air to enter but not to exit to the extracranial space. 1,10,12 A previous study reported that a dural defect could be a one-way valve after craniotomy.…”

Section: Discussionmentioning

confidence: 99%

“… 1 – 3 TP sometimes occurs in low cerebrospinal fluid (CSF) pressure situations, such as with CSF leakage owing to trauma or ventriculoperitoneal (VP) shunts. 4 – 9 A previous study reported TP following cranioplasty in a shunted patient. 2 This current case report describes a patient with TP following cranioplasty without a cause of low CSF pressure.…”

Section: Introductionmentioning

confidence: 99%

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Tension pneumocephalus following cranioplasty with a titanium plate: a case report

et al. 2022

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Tension pneumocephalus (TP) can be a life-threatening postoperative complication, but there are limited data owing to its exceedingly low frequency. A 48-year-old man that suffered a head injury survived the acute phase and cranioplasty was performed using a titanium plate. Progressive deterioration of consciousness occurred the day after the cranioplasty. Computed tomography showed the presence of expanded air in the left epidural cavity and a midline shift to the right side. Emergency skin flap reopening was performed. Tension of the scalp decreased when the skin suture was cut and the wound reopened. Lucidity and improved right hemiparesis were obtained within a few hours after drain insertion. Pooled air in the left epidural cavity gradually dissipated postoperatively and the epidural drain was removed 2 days after insertion. The patient was discharged 27 days after cranioplasty, with a modified Rankin scale score of 2. The mechanism that caused TP was considered. Specifically, the skin flap acted as a one-way valve and trapped air. Then the trapped air expanded as the patient’s body temperature warmed. TP should be considered a differential diagnosis after craniotomy. Emergency skin flap reopening and drain insertion may be an effective treatment for TP in the epidural space.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tension pneumocephalus following cranioplasty with a titanium plate: a case report

et al. 2022

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“…Pneumocephalus in the presence of a shunt is also a well described complication in the literature. The underlying mechanisms is thought to be a combination of an excessively negative intracranial pressure generated by the shunt and the presence of a cranial-dural defect (9).…”

Section: Discussionmentioning

confidence: 99%

Tension Pneumocephalus after Endoscopic Paranasal Sinus Surgery

Çevik¹,

Yüksel²,

Hanımoğlu³

2017

J Basic Clin Health Sci

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Tension pneumocephalus (TP) which produces increased intracranial pressure and leads to neurological deterioration is a rare but life-threatening complication. A 59-year-old male patient who had undergone endoscopic sinus surgery was admitted to the emergency room with severe headache, nausea, and vomiting. Cranial computed tomography revealed pneumocephalus. Endoscopic surgery under general anesthesia was performed again, and a dural tear at the crista galli was identified and repaired using an autograft and fibrin glue. In same session, burr-hole drainage was also performed. He recovered after few days and was discharged. Therefore, following endoscopic sinus surgery, surgeons should be aware of the development of pneumocephalus, a rare but life-threatening complication.

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Tension pneumocephalus in a patient with NF1 following ventriculoperitoneal shunt—deciphering the cause and proposed management strategy

et al. 2023

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Delayed spontaneous pneumocephalus in ventriculoperitoneal shunting: Two case reports and literature review

Cited by 4 publications

References 16 publications

Tension pneumocephalus following cranioplasty with a titanium plate: a case report

Tension pneumocephalus following cranioplasty with a titanium plate: a case report

Tension Pneumocephalus after Endoscopic Paranasal Sinus Surgery

Tension pneumocephalus in a patient with NF1 following ventriculoperitoneal shunt—deciphering the cause and proposed management strategy

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