Tension pneumocephalus and pneumorachis secondary to subarachnoid pleural fistula.

Lin, M. B. K.; Cheah, Foong Koon; Ng, Shonda; Yeo, Tseng Tsai

doi:10.1259/bjr.73.867.10817052

Cited by 33 publications

(27 citation statements)

References 13 publications

(25 reference statements)

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“…We searched PubMed and found some case reports of pneumocephalus/pneumorrhachis due to a CSF fistula that was associated with surgery. Various types of surgery were reported, but majority were lung resection 3,5,6) and the spinal surgery 4,7,9,11) . In almost all reported cases, the intervals between surgery and the development of pneumocephalus/pneumorrhachis were relatively short, from a few days 5,7,9,11) to a few months 3,4) , but the few cases of several years after the surgery were also reported 6,10) .…”

Section: Discussionmentioning

confidence: 99%

“…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%

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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: Discussionmentioning

confidence: 99%

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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“…The most characteristic sign of pneumocephalus is the bruit hydro-aerique, which is a splashing sound heard only by the patient on postural change [5]. In the case presented here acute loss of consciousness and a dilated right pupil were the main signs.…”

Section: Discussionmentioning

confidence: 67%

Cerebellar haemorrhage and tension pneumocephalus after resection of a Pancoast tumour

Ladehoff

Zachow

Koch

et al. 2004

Acta Neurochir (Wien)

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We present an unusual case of cerebellar haemorrhage followed by tension pneumocephalus several days after thoracotomy for resection of a Pancoast tumour. The postoperative course of the 32-year-old patient was complicated by a cerebellar haemorrhage and hydrocephalus caused by compression of the fourth ventricle. Immediate surgical evacuation of the haemorrhage and placement of an external ventricular drain was performed. Respirator ventilation maintaining a continuous positive airway pressure was required. Following weaning and extubation the patient rapidly deteriorated and became comatose. A cranial CT scan revealed a dilated ventricular system filled with air, and air in the subarachnoid space. Recovery of consciousness was observed after aspiration of intracranial air through the ventricular drainage. Recurrent deterioration of consciousness after repeated air aspiration indicated rapid refilling of the ventricles with air.The patient underwent emergency surgical re-exploration of the thoracic resection cavity: dural lacerations of the cervico-thoracic nerve roots C8 and Th1 were identified. Subarachnoid-pleural fistula, cerebellar haemorrhage and tension pneumocephalus after discontinuation of continuous positive airway pressure respiration are unusual complications of thoracic surgery. We discuss the putative pathomechanisms and present a brief review of the literature.

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“…Pneumorrhachis can also be complicated by marijuana smoking [5], mechanical artificial ventilation and chest tube placement [6], it can be spontaneous [7,8] or can also develop after strenuous exercise [9]. Finally pneumorrhachis can develop secondary to a subarachnoid pleural fistula [10].…”

Section: Discussionmentioning

confidence: 99%

“…Neurologic symptoms attributed to intraspinal air are rare [16] but compressive symptoms may develop. Pneumorrhachis can even be under tension [10,11] and decompression treatment (e.g. laminectomy) may be required [11].…”

Section: Outcomementioning

confidence: 99%

Pneumorrhachis: a Rare Finding on Computed Tomography scans

Kakel

Kennedy

2011

Clin Neuroradiol

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Tension pneumocephalus and pneumorachis secondary to subarachnoid pleural fistula.

Abstract: A case of tension pneumocephalus and pneumorachis secondary to a subarachnoid pleural fistula after thoracic spinal surgery is described. This rare complication was diagnosed on CT. The imaging findings, significance and management of this unusual condition are discussed.

Cited by 33 publications

References 13 publications

A Case of Broncho-Paraspinal Fistula Induced by Metallic Devices: Delayed Complication of Thoracic Spinal Surgery

A Case of Broncho-Paraspinal Fistula Induced by Metallic Devices: Delayed Complication of Thoracic Spinal Surgery

Cerebellar haemorrhage and tension pneumocephalus after resection of a Pancoast tumour

Pneumorrhachis: a Rare Finding on Computed Tomography scans

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