Diffuse Pneumocephalus : A Rare Complication of Spinal Surgery

Yun, Jung Ho; Kim, Young Jin; Yoo, Do-Sik; Ko, Jung Ho

doi:10.3340/jkns.2010.48.3.288

Cited by 34 publications

(49 citation statements)

References 14 publications

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“…We searched PubMed and found some case reports of pneumocephalus/pneumorrhachis due to a CSF fistula that was associated with surgery. Various types of surgery were reported, but majority were lung resection 3,5,6) and the spinal surgery 4,7,9,11) . In almost all reported cases, the intervals between surgery and the development of pneumocephalus/pneumorrhachis were relatively short, from a few days 5,7,9,11) to a few months 3,4) , but the few cases of several years after the surgery were also reported 6,10) .…”

Section: Discussionmentioning

confidence: 99%

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A Case of Broncho-Paraspinal Fistula Induced by Metallic Devices: Delayed Complication of Thoracic Spinal Surgery

Son

Kang

Choi

et al. 2011

J Korean Neurosurg Soc

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We present a case report of a 45-year-old woman with spontaneous pneumocephalus accompanied by pneumorrhachis of the thoracic spine, which is a very rare condition generally associated with trauma and thoracic or spinal surgery. The patient had undergone an operation about 10 years earlier to treat a giant cell tumor of the thoracic spine. During the operation, a metallic device was installed, which destroyed the bronchus and caused the formation of a broncho-paraspinal fistula. This is the suspected cause of her pneumocephalus and pneumorrhachis. To our knowledge, this is a very rare case of pneumocephalus accompanied by pneumorrhachis induced by metallic device, and when considering the length of time after surgery these complications presented are also exceptional.

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Section: Discussionmentioning

confidence: 99%

“…Therefore, we considered the well-known etiology of spontaneous pneumocephalus, which has several suggested mechanisms for its development 10,11) . One potential mechanism is that air enters the intracranial cavity through a defect in the skull (known as the ball valve mechanism).…”

Section: Discussionmentioning

confidence: 99%

A Case of Broncho-Paraspinal Fistula Induced by Metallic Devices: Delayed Complication of Thoracic Spinal Surgery

Son

Kang

Choi

et al. 2011

J Korean Neurosurg Soc

View full text Add to dashboard Cite

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“…A small amount of the air is asymptomatic and misleading and resolves spontaneously after a few days, however, high inspired oxygen concentration can accelerated its absorption (11). Surgical intervention in order to repair dura mater defects should only be performed when there is neurological deficit, persistent CSF leakage or infection (1,12). Simple X ray, CT scan or MRI diagnose the air in spinal and cranial space.…”

Section: Discussionmentioning

confidence: 99%

“…Pneumocephalus is commonly established after neurosurgical procedure due to iatrogenic spinal dura tear, but it can also be the result of trauma (1). Post traumatic fractures of temporal bone air cells or paranasal sinuses or skull base can cause dura lacerations and pneumocephalus (1,2).…”

Section: Introductionmentioning

confidence: 99%

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Pneumocephalus and Neurologic Deficit Due to Neck Stab Wound in a Twenty Nine-Year-Old Man

Rana¹,

Kakhki²,

Choobdari³

et al. 2016

Razavi Int J Med

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Introduction: The presence of air within the intracranial cavity, due to the entry of air secondary to an abnormal communication after a dural tear, is defined as pneumocephalus and intraventricular pneumocephalus also known as pneumoventricle. Obviously, common etiologies of pneumocephalus are head injury and cranial surgery. Also, less common non-traumatic causes of pneumocephalus are neoplasm or from a gas-forming organism infection. Although pneumocephalus after spinal penetrating injuries is rare,it was reported. The object of this report is to describe the case of patient with pneumoventricle after neck spinal stab wound. Case Presentation: A 29-year-old man presented to ED with complaint of two stab wounds, one of them was located at the right back chest and the other at the midline neck. Because of the respiratory distress and decreased breath sounds, after taking a chest X-ray, we realized hemothorax in right hemithorax and placed the chest tube in ED. In addition, in requested neck CT scan, there was a defuse air in neck spine that spread to his brain. Furthermore, neurologic examination showed weakness in left leg motor function and loss of pain and temperature sensation in the other leg, which was based on brown-sequard syndrome. Mentioned patient admitted in neurosurgery department for further follow-up. Conclusions: Pneumoventricle is rare but it can be established after spinal trauma. By awareness of such possibility, accurate diagnosis by clinical examination and imaging is essential for these types of injuries

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Pneumorrhachis following cervical spine surgery

Bautista

Wright

Pippalapalli

et al. 2021

Anaesthesia Reports

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A 66-year-old man experienced symptomatic pneumorrhachis (air within the spinal canal) following a cervical laminoplasty for the excision of meningioma. Following an uneventful intraoperative course, he suffered a fluctuating hemiparesis of varying severity. Urgent imaging demonstrated extradural and intradural air in the spinal canal. Treatment with supplemental oxygen and dexamethasone was commenced, and the patient's symptoms improved over a period of three days with full resolution at six weeks. Pneumorrhachis can be avoided by allowing air to escape from the spinal canal through positioning, and displacement with irrigation fluid at the time of wound closure. However, if pneumorrhachis does occur, oxygen therapy, positioning of the patient to mitigate the gravitational effect of the air bubbles and supportive treatment are the central elements of management. Other possible causes of neurological deficit should be ruled out. This is particularly important as treatment options for some differential diagnoses can potentially cause harm if started based on clinical impression alone, for example, re-exploration for suspected haematoma. Only a small number of previous reports have described symptomatic pneumorrhachis as a complication of spinal surgery. This patient was successfully managed with conservative measures following the exclusion of other spinal cord pathologies.

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Diffuse Pneumocephalus : A Rare Complication of Spinal Surgery

Cited by 34 publications

References 14 publications

A Case of Broncho-Paraspinal Fistula Induced by Metallic Devices: Delayed Complication of Thoracic Spinal Surgery

A Case of Broncho-Paraspinal Fistula Induced by Metallic Devices: Delayed Complication of Thoracic Spinal Surgery

Pneumocephalus and Neurologic Deficit Due to Neck Stab Wound in a Twenty Nine-Year-Old Man

Pneumorrhachis following cervical spine surgery

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