Pneumorachis and pneumocephalus caused by pneumothorax and multiple thoracic vertebral fractures

Katz, Douglas S.; Groskin, Stuart A.; Wasenko, John J.

doi:10.1016/0899-7071(94)90154-6

Cited by 43 publications

(30 citation statements)

References 8 publications

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“…Pneumocephalus, the presence of air in the intracranial cavity, accompanied by pneumorrhachis, the presence of air within the spinal canal, is very rare condition generally associated with trauma 1) and thoracic or spinal surgery 3,4) . We experienced a patient with spontaneous pneumocephalus accompanied by pneumorrhachis of the thoracic spine.…”

Section: Introductionmentioning

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

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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: Introductionmentioning

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

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“…Several reports of fracture-dislocations in the thoracic spine without associated spinal cord injury have been published [4,5]. Two recent papers reported on the presence of air in the spinal canal in conjunction with thoracic trauma [2,3]. Laceration of bronchus with clinical significance resulting from anterior displacement of the spiculae of a thoracic vertebral body fracture, to our knowledge, has not been previously reported.…”

Section: Discussionmentioning

confidence: 89%

“…Spinal trauma frequently results from high-energy vehicular accidents, which may produce multisystem trauma [2][3][4][5]7]. Because of the priorities of resuscitation, other injuries may escape early diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Unrecognized laceration of main bronchus caused by fracture of the T6 vertebra

Korovessis

Stamatakis²,

Baikousis³

1998

European Spine Journal

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IntroductionSpinal trauma frequently results from high-energy vehicular accidents, which may produce multisystem trauma [2][3][4][5]7]. Because of the priorities of resuscitation, other injuries may escape early diagnosis. This study reports on an extremely rare case of laceration of the bronchus by fragments of a bursting vertebral fracture that was not diagnosed on admission. Case reportA 58-year-old man riding a motorcycle was hit by a car. On admission, the patient was in an excellent general condition, without cardiovascular or respiratory complaints. Physical examination revealed displaced ankle fractures bilaterally and a displaced olecranon fracture on the left. Lateral roentgenograms of the spine revealed a fracture of the T6 vertebra, while the CT scan revealed a bursting of its vertebral body (Fig. 1). Lung sounds and respiratory airway pressures were normal and the roentgenograms of the thorax in supine position were within normal limits; in particular, no hemothorax or pneumothorax was found. Ultrasound scanning of the abdomen (to examine the liver and spleen parenchyma and check for bleeding) [1] revealed no pathological findings in the abdominal cavity or retroperitoneal space. The neurologic examination showed regular intrinsic muscle reflexes, both motor and sensory, in the upper and lower extremities. Two days after admission it was planned to stabilize the ankle and olecranon fractures under general anesthesia. The patient was placed in supine position for introduction of the general anesthesia. Immediately after introduction of the endotracheal tube and application of positive pressure by the anesthetist, a curious sound was observed inside the chest, which was followed by an increasing distention of the abdomen, without reverse filling of the ventilation balloon during the passive expiration. In other words, the volume of air passively inspirated through the tube was not followed by the passive expiration of an equal air volume. There appeared to be a significant concentration of the mechanically inspirated air somewhere inside the body. Initially it was supposed that the tube was not correctly positioned in the trachea. Thus, although the anesthetist performed repeated intubations in order to secure absolutely correct intubation (avoiding the esophagus, ensuring good contact of the tube on the inner surface of the trachea, etc.), the result was always the same. An increasing distention of the abdomen was observed during ventilation of the lungs with positive pressure, whereas when the tube was removed the distention decreased in a few seconds. Repeated blood gas analyses showed normal saturation and base levels, and the PO 2 , PCO 2 , and PH values were within normal limits for the age, height, and sex of the patient. Further anteroposterior and lateral chest roentgenograms in supine position on the operation table AbstractWe report on an extremely rare case of a 58-year-old male polytraumatized patient who sustained a bursting fracture of the T 6 vertebral body associated with laceration o...

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“…Because air must be expelled from an air-containing space in order to enter the spinal canal, a number of sites are possible. For example, the lungs, mediastinum, mastoid air cells or frontal sinuses, vertebral disc, or intestine can release air that may track into the spinal canal (1)(2)(3)(4)(5)(6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%