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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
- 46,516 View
- 638 Download
- 10 Web of Science
- 15 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
- Occurrence of postoperative pneumoencephalus in posterior fossa surgery using the semi-sitting position: Prevalence, factors and patterns
Liezel Ulloque-Caamaño, Mario Gomar-Alba, Benjamin Romero-Leguina, Nadin J. Abdala-Vargas, Juan F. Villalonga, Álvaro Campero
Neurocirugía (English Edition).2026; : 500763. CrossRef - Otogenic pneumocephalus from an unrecognized mastoid defect
Ummi Humaira Zulkeply, Iffah Salim, Mohd Khairi Md Daud
Visual Journal of Emergency Medicine.2026; 43: 102481. CrossRef - Fatal postoperative tension pneumocephalus after acute subdural hematoma evacuation: a case report
Nikolaos Gkantsinikoudis, Panagiotis Monioudis, Elias Antoniades, Vassilios Tsitouras, Ioannis Magras
International Journal of Neuroscience.2025; 135(11): 1237. CrossRef - Pro-Con Debate: Air or Saline for Loss-of-Resistance Technique of Interlaminar Epidural Access with Fluoroscopy-Guided Pain Medicine Procedures
David Hao, Kirk Bonner, Taylor Burnham, Milan P. Stojanovic
Anesthesia & Analgesia.2025; 141(1): 103. CrossRef - A case of cerebrospinal fluid (CSF) leak and pneumocephalus in a 52-year-old with a pituitary adenoma
Barbara Magid, Lauren Titone, Tyler Wise
Visual Journal of Emergency Medicine.2025; 38: 102153. CrossRef - A Rare Case of Post-lumbar Discectomy Pneumocephalus: An Anatomically Informed Case Report
Yasir H Elhassan, Mustafa Alhasan, Yasser S Abdulghani
Cureus.2025;[Epub] CrossRef - Etiology of Intracranial Pneumocephalus: A Retrospective Comparative Study of Traumatic and Iatrogenic Causes in Emergency Patients
Mehdi Hekimoğlu, Hıdır Özer
Medical Records.2025; 7(2): 476. CrossRef - Spontaneous extensive pneumocephalus following frontal sinus defect
Kaavya Venkatesh, Nitin Mukerji, Devasmitha Venkataraman
BMJ Case Reports.2025; 18(5): e263987. CrossRef - Atraumatic Tension Pneumocephalus in a Shunted Patient: A Case of Rapid Neurological Decline
Lily D Rundquist, Jomaris O Gomez-Rosado, Christopher Nunez, Aleksandr Dubrovskiy
Cureus.2025;[Epub] CrossRef - 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 After Lumbar Epidural Steroid Injection: A Rare Complication With Spontaneous Resolution
Yasser Hegazy, Natalie N Balassiano, Ishank Gupta, Roger Stern, Muhammad Ghallab
Cureus.2024;[Epub] 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
- Occurrence of postoperative pneumoencephalus in posterior fossa surgery using the semi-sitting position: Prevalence, factors and patterns
- 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
- 8,214 View
- 63 Download
- 2 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- Isolated reversible mydriasis was associated with the use of nebulized ipratropium bromide: a case series using quantitative pupilometer in Korea
Soo-Hyun Park, Tae Jung Kim, Sang-Bae Ko
Acute and Critical Care.2024; 39(4): 593. CrossRef - 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
- Isolated reversible mydriasis was associated with the use of nebulized ipratropium bromide: a case series using quantitative pupilometer in Korea
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