Posttraumatic delayed tension pneumocephalus: Rare case with review of literature

Abstract

Pneumocephalus is commonly seen after head and facial trauma, ear infections, and tumors of the skull base or neurosurgical interventions. In tension pneumocephalus, the continuous accumulation of intracranial air is thought to be caused by a “ball valve” mechanism. In turn, this may lead to a mass effect on the brain, with subsequent neurological deterioration and signs of herniation. Tension pneumocephalus is considered a life-threatening, neurosurgical emergency burr-hole evacuation was performed and he experienced a full recovery. However, more invasive surgery was needed to resolve the condition. Delayed tension pneumocephalus is extremely rare and considered a neurosurgical emergency. Pneumocephalus is a complication of head injury in 3.9–9.7% of the cases. The accumulation of intracranial air can be acute (<72 h) or delayed (≥72 h). When intracranial air causes intracranial hypertension and has a mass effect with neurological deterioration, it is called tension pneumocephalus. We represent a clinical case of a 30-year-old male patient with involved in a road traffic accident, complicated by tension pneumocephalus and cerebrospinal fluid rhinorrhea on 1 month after trauma and underwent urgent surgical intervention. Burr-hole placement in the right frontal region, evacuation of tension pneumocephalus. Tension pneumocephalus is a life-threatening neurosurgical emergency case, which needs to undergo immediate surgical intervention.

The man that lost (part of) his mind

“…Clinical presentation of a pneumocephalus can range from an asymptomatic incidental finding to presentation with headache, agitation, delirium, seizure, decreased mental status as well as focal neurological deficits depending on the location 6. These common, often non-specific symptoms are not infrequently encountered in primary care or accident and emergency (A&E) consultation but would not commonly be attributed to a pneumocephalus unless aided by clinical suspicion and/or neuroimaging.…”

A Rare Case of Spontaneous Pneumocephalus as a Complication of Nontraumatic Nasal Liquorrhea

“…The ventricular system is not enlarged, except for the anterior horns of the lateral ventricles, in which there is an accumulation of air. Convex subarachnoid spaces are not expanded [5,6]. The median structures are not biased.…”

Delayed Posttraumatic Tension Pneumocephalus: A Rare Case Report and Review of the Literature

“…By contrast, "spontaneous" PNC has been very rarely reported [1,2]. The rate at which the air accumulates inside the cranium could be acute (<72 h) or delayed (≥72 h) [3]. PNC has two clinical entities: simple and Tension PNC (TP).…”