Pneumocephalus in the Absence of Craniofacial Skull Base Fracture

Choi, Youn Jeong; Hyun, Dong-Keun; Park, Hyung-Chun; Park, Chong-Oon

doi:10.1097/01.ta.0000229049.11274.96

Cited by 12 publications

(8 citation statements)

References 16 publications

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“…Pneumocephalus was reported to develop due to various etiologies such as thoracic stab wounds, tube thoracostomy, cardiopulmonary resuscitation, injury of the spinal area and neck, central venous catheterization or even in the absence of any air entrance point 14, 15, 16, 17, 18, 19. Pneumocephalus in our case can not be attributed to a vague cause but could have happened due to several reasons.…”

Section: Discussionmentioning

confidence: 63%

Pneumocephalus in a patient with multiple stab wounds

Savran

Karaçam

Bayram

et al. 2017

Turkish Journal of Emergency Medicine

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Pneumocephalus is a complication of trauma to the chest and many iatrogenic interventions. It may arise due to systemic air embolism or retrograde cerebral venous air embolism which is an extremely rare complication. We report a 26-years-old female patient who presented to the Emergency Department suffering of multiple stab wounds. She was in a state of shock and after first aid and evaluation she was operated successfully. In the early postoperative period generalized tonic clonic convulsions were observed following cardiopulmonary resuscitation due to sudden cardiovascular collapse. Brain computerized tomography demonstrated free air in intracranial and extracranial venous structures. Pneumocephalus was diagnosed which may be due to a wide spectrum of etiologies including thorax or spinal stab wounds, tube thoracostomy, cardiopulmonary resuscitation or even central venous catheterization. Unfortunately, the patient ended up with brain death despite all effort. In conclusion, we recommend physicians to be aware of this catastrophic complication while taking care of patients with stab wounds.

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Section: Discussionmentioning

confidence: 63%

Pneumocephalus in a patient with multiple stab wounds

Savran

Karaçam

Bayram

et al. 2017

Turkish Journal of Emergency Medicine

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“…Thus, the pneumocephalus was due to intracranial gas extension through the carotid canal, jugular foramen, foramen lacerum, or foramen oval through the skull base. [ 4 ]…”

Section: Discussionmentioning

confidence: 99%

Unilateral blindness following superior laryngeal nerve block for awake tracheal intubation in a case of posterior cervical spine surgery

Akhaddar

Baallal

Hammoune

et al. 2020

Surgical Neurology International

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Background: Superior laryngeal nerve block (SUPLANEB) is a popular airway anesthesia technique utilized for successful awake endotracheal intubation in patients with significant cervical spine instability. If not performed by an expert, it carries the risk of general/neurologic complications that are typically minimal/transient. However, permanent blindness and/or upper cranial nerve neuropathies may occur. Here, we describe a case in which a young patient underwent an atlantoaxial fusion for a C2 nonunion (e.g., following a fracture) complicated by unilateral blindness due to a SUPLANEB. Case Description: A 25-year-old neurologically intact male underwent a C1-C2 posterior arthrodesis to address a nonunion of a C2 fracture. To perform the awake nasotracheal intubation, a SUPLANEB was performed using a video laryngoscope. Although the operation was uneventful, postoperatively, the patient reported left visual loss accompanied by left-sided facial numbness and hearing loss. On examination of the left eye, the anterior segment and fundus examinations were normal, but the OCT (optical coherence tomography) and retinal angiography demonstrated left-sided postischemic retinal edema with permeability of the intraocular vessels. Although the cranio-orbital computed tomography scan showed only mild pneumocephalus, the CT angiogram scan revealed abnormal air in the left carotid sheath accompanied by diffuse subcutaneous emphysema. Further, brain and orbital magnetic resonance imaging scans were normal. The patient was treated with pure oxygen, systemic steroid therapy, and nimodipine. The pneumocephalus and subcutaneous emphysema resolved on day 3. At 2 months follow-up, the patient remained blind on the left side, but had no further neurological deficits. Conclusion: Blindness and upper cranial nerves neuropathies should be considered as potential complications of SUPLANEB. Notably, these deficits were not directly related to the operative positioning or neurosurgical spinal procedure.

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“…It is reported that pneumocephalus has an incidence of less than 1% in patients with head trauma [1]. Very few reports exist of patients developing pneumocephalus without skull fracture; however, these cases still report head trauma [1,5,6]. Pneumocephalus without prior head trauma or injury has not been reported.…”

Section: Discussionmentioning

confidence: 99%