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- What should an intensivist know about pneumocephalus and tension pneumocephalus?
- Bhushan Sudhakar Wankhade, Maged Mohsen Kamel Beniamein, Zeyad Faoor Alrais, Jyoti Ittoop Mathew, Ghaya Zeyad Alrais
- Acute Crit Care. 2023;38(2):244-248. Published online April 13, 2022
- DOI: https://doi.org/10.4266/acc.2021.01102
- 12,674 View
- 346 Download
- 4 Web of Science
- 5 Crossref
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Abstract
PDF - Collection of air in the cranial cavity is called pneumocephalus. Although simple pneumocephalus is a benign condition, accompanying increased intracranial pressure can produce a life-threatening condition comparable to tension pneumothorax, which is termed tension pneumocephalus. We report a case of tension pneumocephalus after drainage of a cerebrospinal fluid hygroma. The tension pneumocephalus was treated with decompression craniotomy, but the patient later died due to the complications related to critical care. Traumatic brain injury and neurosurgical intervention are the most common causes of pneumocephalus. Pneumocephalus and tension pneumocephalus are neurosurgical emergencies, and anesthetics and intensive care management like the use of nitrous oxide during anesthesia and positive pressure ventilation have important implications in their development and progress. Clinically, patients can present with various nonspecific neurological manifestations that are indistinguishable from a those of a primary neurological condition. If the diagnosis is questionable, patients should be investigated using computed tomography of the brain. Immediate neurosurgical consultation with decompression is the treatment of choice.
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Citations
Citations to this article as recorded by
- Sudden-onset, non-traumatic large volume pneumocephalus following presentation of acute bacterial meningitis
Alexandra Krez, Michael Malinzak, Colby Feeney
BMJ Case Reports.2024; 17(1): e256194. CrossRef - Pneumocephalus; a rare cause of coma
Elisavet Simoulidou, Vivian Georgopoulou, Panagiotis Kalmoukos, Dimitrios Kouroupis, Nikoleta Moscha, Maria Sidiropoulou, Sofia Chatzimichailidou, Konstantinos Petidis, Athina Pyrpasopoulou
The American Journal of Emergency Medicine.2023; 68: 215.e1. CrossRef - Pneumocephalus secondary to epidural analgesia: a case report
Maira Ahmad, Shannay Bellamy, William Ott, Rany Mekhail
Journal of Medical Case Reports.2023;[Epub] CrossRef - Transnasal Endoscopic Treatment of Tension Pneumocephalus Caused by Posttraumatic or Iatrogenic Ethmoidal Damage
Goran Latif Omer, Riccardo Maurizi, Beatrice Francavilla, Kareem Rekawt Hama Rashid, Gianluca Velletrani, Hasan Mustafa Salah, Giulia Marzocchella, Mohammed Ibrahim Mohialdeen Gubari, Stefano Di Girolamo, Rong-San Jiang
Case Reports in Otolaryngology.2023; 2023: 1. CrossRef - Tension pneumocephalus as a complication of surgical evacuation of chronic subdural hematoma: case report and literature review
Mohammed A. Azab, Ahmed Hazem, Brandon Lucke-Wold
Exploration of Neuroprotective Therapy.2023; 3(4): 177. CrossRef
- Sudden-onset, non-traumatic large volume pneumocephalus following presentation of acute bacterial meningitis
- Neurosurgery
- Therapeutic Hypothermia after Decompressive Craniectomy in Malignant Cerebral Infarction
- Jun Young Chang, Jeong Ho Hong, Jin Heon Jeong, Sung Jin Nam, Ji Hwan Jang, Jae Seung Bang, Moon Ku Han
- Korean J Crit Care Med. 2014;29(2):93-98. Published online May 31, 2014
- DOI: https://doi.org/10.4266/kjccm.2014.29.2.93
- 5,075 View
- 52 Download
- 1 Crossref
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Abstract
PDF
- Decompressive hemicraniectomy followed by subsequent therapeutic hypothermia can reduce mortality in patients with malignant cerebral infarction without significantly increasing risk. We report three cases of malignant cerebral infarction treated with hemicraniectomy followed by hypothermia. Case 1 received elective decompressive surgery and hypothermia. Case 2 developed subsequent cerebral infarction with uncal herniation. Therefore, emergent decompressive surgery and hypothermia was performed in this case. Despite surgery and hyperosmolar therapy, case 3 received hypothermia treatment for refractory increased intracranial pressure. All patients survived with a score of 4 or 5 on the modified Rankin scale. Therefore, we suggest that application of hypothermia after hemicraniectomy is safe and feasible. Several possible modifications can be made to improve the management strategy in order to increase the benefits of hypothermia treatment.
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Citations
Citations to this article as recorded by- Dexmedetomidine Use in Patients with 33℃ Targeted Temperature Management: Focus on Bradycardia as an Adverse Effect
Hyo-yeon Seo, Byoung-joon Oh, Eun-jung Park, Young-gi Min, Sang-cheon Choi
The Korean Journal of Critical Care Medicine.2015; 30(4): 272. CrossRef
- Dexmedetomidine Use in Patients with 33℃ Targeted Temperature Management: Focus on Bradycardia as an Adverse Effect
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