| Traumatic tension pneumocephalus after blunt head trauma and positive pressure ventilation. | |
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MedLine Citation:
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PMID: 20095833 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Pneumocephalus following head trauma is relatively rare, with tension pneumocephalus occurring in an even smaller group of patients. This review presents a recent case of tension pneumocephalus following the use of a manually operated bag-valve-mask to assist ventilations prior to rapid-sequence intubation. A discussion of this case in terms of other reported cases of pneumocephalus after oxygen therapy follows. A limited number of current case reports identified in the literature indicate a connection between pneumocephalus and positive pressure ventilation following blunt trauma. Continuous positive airway pressure (CPAP) ventilation use in patients with an undiagnosed skull fracture is the most common reported cause of ventilation-related pneumocephalus. The case review presented here identifies the use of a bag-valve-mask prior to intubation as a possible contributory cause of the tension pneumocephalus. With only one prior case reported in the literature of pneumocephalus following the use of a bag-valve-mask, this case is unique and may indicate the need for additional awareness for this rare complication. The prehospital diagnosis of pneumocephalus is difficult, as the symptoms and mechanism of injury mimic those associated with intracranial hemorrhage. The use of mannitol in the prehospital treatment of this patient and subsequent improvement in pupillary response may indicate that mannitol has a role in the treatment of tension pneumocephalus when neurosurgical services are not readily available. Additional research is needed to better understand the benefits and risks associated with this treatment modality. |
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Authors:
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Benjamin Nicholson; Harinder Dhindsa |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors Volume: 14 ISSN: 1545-0066 ISO Abbreviation: Prehosp Emerg Care Publication Date: 2010 Oct-Dec |
Date Detail:
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Created Date: 2010-09-02 Completed Date: 2011-01-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9703530 Medline TA: Prehosp Emerg Care Country: England |
Other Details:
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Languages: eng Pagination: 499-504 Citation Subset: IM |
Affiliation:
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LifeEvac of Virginia, LifeEvac 3, 1000 Airport Road, Mattaponi, VA 23110, USA. nicholsonbd@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult France Head Injuries, Closed / complications* Humans Male Pneumocephalus / etiology* Positive-Pressure Respiration* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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