Does the Mount Fuji Sign always signify ‘tension’ pneumocephalus? An exception and a reappraisal

Jakhere, Sandeep; Yadav, Deepak; Jain, Darshan G; Balasubramaniam, Srikant

doi:10.1016/j.ejrex.2011.01.002

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…Similarly, Sandeep et al . [ 23 ] proposed that Mount Fuji sign does not always signify tension pneumocephalus and may be seen in a few subsets of patients with non-tension pneumocephalus. Other complex mechanisms rather than just physical compression of frontal lobes may be responsible for the clinical symptoms and require further elucidation.…”

Section: Discussionmentioning

confidence: 99%

“…[14,21,22] Mount Fuji sign alone in not considered a diagnostic for tension pneumocephalus in the present study as it was present in four cases; only two of them were associated with neurological deficit and diagnosed as tension pneumocephalus while the other two cases were asymptomatic. Similarly, Sandeep et al [23] proposed that Mount Fuji sign does not always signify tension pneumocephalus and may be seen in a few subsets of patients with non-tension pneumocephalus. Other complex mechanisms rather than just physical compression of frontal lobes may be responsible for the clinical symptoms and require further elucidation.…”

Section: Diagnosis Of Tension Pneumocephalusmentioning

confidence: 99%

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Pneumocephalus after surgical evacuation of chronic subdural hematoma: Is it a serious complication?

Zidan

2012

Asian J Neurosurg

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Background:Pneumocephalus is commonly encountered after surgical evacuation of chronic subdural hematoma (CSDH). This study was done to study the incidence, clinical presentation, and management of patients who developed pneumocephalus after surgical evacuation of CSDH.Materials and Methods:This prospective study was carried out on consecutive 50 patients who had received surgical treatment for CSDH. All the patients included were followed-up postoperatively with regular clinical and computed tomography (CT) examinations immediately postoperatively, before discharge, and 2 months after surgery. Pneumocephalus was classified into simple and tension, based upon the clinical and radiological criteria. The neurologic grading system of Markwalder et al was used to evaluate the surgical results.Results:The immediate postoperative CT scan showed pneumocephalus in 22 patients (44%). Tension pneumocephalus was found in two patients who did not require any further surgery. There was statistically significant increase in the incidence of pneumocephalus (immediate and postoperative) in the patients aged over 60 years as well as those presenting with a midline shift more than 5 mm in their CT scan. With regard to the 22 cases of pneumocephalus, good postoperative results were found in 16 patients (73%), while bad results were found in 6 patients (27%). No statistically significant difference in the outcome between patients who had pneumocephalus after surgery and those who had not.Conclusion:Pneumocephalus after surgical evacuation of CSDH is a common finding in the immediate CT scan as well as at time of discharge. Tension pneumocephalus may not require surgical intervention and simple aspiration of air using a syringe may be sufficient.

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Section: Discussionmentioning

confidence: 99%

Section: Diagnosis Of Tension Pneumocephalusmentioning

confidence: 99%

Pneumocephalus after surgical evacuation of chronic subdural hematoma: Is it a serious complication?

Zidan

2012

Asian J Neurosurg

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Tension pneumocephalus: a case report with review of literature

Shah

Balamurugan

Thirumalaikolundusubramanian³

2013

Emerg Radiol

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Tension Pneumocephalus (PC) was described 50 years ago. A case of pneumocephalus (PC) following cervical epidural injection in a 50-year-old male worsened by air travel and manifested as tension pneumocephalus, confirmed by advanced neuroimaging, is reported for the first time along with literature review. The patient underwent emergent frontal burr hole evacuation and air gushed under pressure. The patient recovered well and is stable during a follow-up of 12 months. Presenting features and clinical course along with Mount Fuji sign, Peaking sign, and air bubble sign observed in this case are described. Also, the importance of considering neurosurgical and spinal procedures leading to PC have to be considered by practitioners before issuing fitness certificate before air travel, as PC is likely to get transformed to tension PC and can cause an in-flight emergency.

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Tension Pneumocephalus from Positive Pressure Ventilation Following Endoscopic Skull Base Surgery: Case Series and an Institutional Protocol for the Management of Postoperative Respiratory Distress

et al. 2020

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Does the Mount Fuji Sign always signify ‘tension’ pneumocephalus? An exception and a reappraisal

Cited by 4 publications

References 13 publications

Pneumocephalus after surgical evacuation of chronic subdural hematoma: Is it a serious complication?

Pneumocephalus after surgical evacuation of chronic subdural hematoma: Is it a serious complication?

Tension pneumocephalus: a case report with review of literature

Tension Pneumocephalus from Positive Pressure Ventilation Following Endoscopic Skull Base Surgery: Case Series and an Institutional Protocol for the Management of Postoperative Respiratory Distress

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