Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2023.07.005
Brazilian Journal of Anesthesiology
Clinical Images

Tension pneumocephalus

Sandeep Khanna, Carlos Trombetta, Kurt Ruetzler, Maged Argalious

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Abstract

Pneumocephalus, defined as presence of air or gas within the compartments of the cranial vault, can occur after neurosurgery and is typically benign. In contrast, tension pneumocephalus occurs when the pressure of the intracranial air collection exceeds atmospheric pressure, leading to brain compression. The resulting increase in intracranial pressure can precipitate nausea and vomiting, headaches, focal neurological deficits, seizures, altered mental status, and death. Consequently, tension pneumocephalus is a neurosurgical emergency. The accompanying images demonstrate this rare complication and are from a patient who underwent craniotomy for meningioma resection. Delayed emergence and bilious vomiting prior to extubation prompted computed tomographic imaging revealing extensive pneumocephalus and the classic Mount Fuji sign in the axial section.

References

1. Schirmer CM, Heilman CB, Bhardwaj A. Pneumocephalus: case illustrations and review. Neurocrit Care. 2010;13:152−8.

2. Satapathy GC, Dash HH. Tension pneumocephalus after neurosurgery in the supine position. Br J Anaesth. 2000;84: 115−7.

3. Michel SJ. The Mount Fuji sign. Radiology. 2004;232:449−50.


Submitted date:
06/02/2023

Accepted date:
07/16/2023

64efb282a95395634b3ce866 rba Articles
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Braz J Anesthesiol

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