Tension Pneumocephalus after Cervical Spine Surgery: A Case Report with Review of the Literature

Maupin, Jeremiah J.; Burrow, Zackary; Shirazi, Cameron; Vallurupalli, Santaram

doi:10.1055/s-0038-1676298

Cited by 2 publications

(2 citation statements)

References 22 publications

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“… 3 Our patient also recovered quicker compared with cases treated with burr holes and dural repair. 2 It should be highlighted that it is difficult to draw definitive conclusions due to the heterogeneity of patient groups as well as small sample size, but – at least in our patient – dural repair with supportive care had similar, if not better, outcomes than reported cases that have been treated with burr holes.…”

Section: Discussionmentioning

confidence: 58%

“…Similar cases of delayed presentation and leaking wounds have also been reported by Gupta et al and Maupin et al , both presenting 1 month after their operations. 2 , 7 Maupin et al reported a clean wound that had sutures removed 2 days prior to re-presentation; 2 Gupta et al did not comment on the wound prior to re-presentation. 7 In our case, we suggest that a delayed presentation of TP is still possible despite a superficially healed wound.…”

Section: Discussionmentioning

confidence: 99%

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Delayed tension pneumocephalus and pneumorrhacis after routine cervical spine surgery treated successfully without burr holes

Lim

Dahapute

Clarke

et al. 2024

annals

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Tension pneumocephalus (TP) after spinal surgery is very rare with only a few cases reported in the English literature. Most cases of TP occur rapidly after spinal surgery. Traditionally, TP is managed using burr holes to relieve intracranial pressure. However, our case highlights a rare delayed presentation of TP and pneumorrhacis 1 month after routine cervical spine surgery. It is to our knowledge the first case of TP after spinal surgery to be treated using dural repair and supportive care. A 75-year-old woman presented with TP after having routine cervical decompression and stabilisation for cervical myelopathy. She re-presented 1 month after her initial operation with a leaking wound and altered mental status, which deteriorated rapidly shortly after admission. This, in combination with her radiographic features, influenced the decision to explore her surgical wound emergently. She made a full recovery and was discharged after 2 weeks in hospital. We hope to emphasise the need for a high index of suspicion for cerebrospinal fluid leaks and the low threshold to return to theatre to repair a potential dural defect, as well as illustrate that TP after spinal surgery can be treated successfully without burr holes.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Delayed tension pneumocephalus and pneumorrhacis after routine cervical spine surgery treated successfully without burr holes

Lim

Dahapute

Clarke

et al. 2024

annals

View full text Add to dashboard Cite

show abstract

Pneumocephalus secondary to a spinal surgery: A literature review and a case report

Abu-Hamdiyah

Sharie

Awadi

et al. 2021

International Journal of Surgery Case Reports

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Introduction We report a case of pneumocephalus, which is identified as the presence of air in the cranial cavity and is a rare complication after spinal surgeries, in addition to a literature review of similarly reported cases. Case presentation The patient is a 63-year-old male who developed pneumocephalus after undergoing a minimally invasive left side decompression at L3-L4 with left L4 foraminotomy even though there were no signs of dural tears or Cerebrospinal Fluid (CSF) leaks. After the diagnosis of pneumocephalus using brain Magnetic Resonance Imaging (MRI), the patient was treated conservatively and was discharged after 3 weeks without developing further complications. Discussion Pneumocephalus is defined as an abnormal accumulation of air within the cranial cavity. It can occur due to a variety of causes but rarely due to gas forming bacteria. Many theories are suggested concerning the pathophysiology of pneumocephalus, the inverted bottle theory, the ball valve theory, the Nitrous Oxide (N 2 O) theory, and as we outweigh in our case, gas forming bacteria theory. Pneumocephalus can be treated surgically, nevertheless, conservative management methods of such cases are usually followed. Conclusion The aim of this study is to draw further attention to the management and diagnosis of such surgical complication. A more extended research is needed to provide a full comprehensive approach to deal with this problem if faced in the future. To the best of our knowledge, this study reports the first pneumocephalus case induced by a postoperative bacterial infection in the global English based medical literature.

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Tension Pneumocephalus after Cervical Spine Surgery: A Case Report with Review of the Literature

Cited by 2 publications

References 22 publications

Delayed tension pneumocephalus and pneumorrhacis after routine cervical spine surgery treated successfully without burr holes

Delayed tension pneumocephalus and pneumorrhacis after routine cervical spine surgery treated successfully without burr holes

Pneumocephalus secondary to a spinal surgery: A literature review and a case report

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