Document Detail


Pneumocephalus: case illustrations and review.
MedLine Citation:
PMID:  20405340     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pneumocephalus is commonly encountered after neurosurgical procedures but can also be caused by craniofacial trauma and tumors of the skull base and rarely, can occur spontaneously. Contributing factors for the development of pneumocephalus include head position, duration of surgery, nitrous oxide (N(2)O) anesthesia, hydrocephalus, intraoperative osmotherapy, hyperventilation, spinal anesthesia, barotauma, continuous CSF drainage via lumbar drain, epidural anesthesia, infections, and neoplasms. Clinical presentation includes headaches, nausea and vomiting, seizures, dizziness, and depressed neurological status. In this article, we review the incidence, mechanisms, precipitating factors, diagnosis, and management of pneumocephalus. Search of Medline, databases, and manual review of article bibliographies. Considering four case illustrations that typify pneumocephalus in clinical practice, we discuss the common etiologies, and confirm the diagnosis with neuroimaging and management strategies. Avoidance of contributing factors, high index of suspicion, and confirmation with neuroimaging are important in attenuating mortality and morbidity. A significant amount of pneumocephalus can simulate a space-occupying lesion. Supplemental oxygen increases the rate of absorption of pneumocephalus.
Authors:
Clemens M Schirmer; Carl B Heilman; Anish Bhardwaj
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Neurocritical care     Volume:  13     ISSN:  1556-0961     ISO Abbreviation:  Neurocrit Care     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-05     Completed Date:  2010-10-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  152-8     Citation Subset:  IM    
Affiliation:
Department of Neurological Surgery, Tufts University School of Medicine, Boston, MA 02111, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenoma / surgery
Adipose Tissue / transplantation
Aged
Arnold-Chiari Malformation / radiography,  surgery
Carcinoma, Squamous Cell / radiography,  surgery
Child
Chronic Disease
Diagnosis, Differential
Hematoma, Subdural / radiography,  surgery
Humans
Male
Middle Aged
Neurosurgical Procedures / adverse effects*
Pituitary Neoplasms / surgery
Pneumocephalus / etiology*,  radiography,  surgery
Reconstructive Surgical Procedures
Skull Base Neoplasms / radiography,  surgery
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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