Cardiac Arrest Associated with Tension Pneumocephalus

Thiagarajah, Somasundaram; Frost, Elizabeth A. M.; Singh, T; Shulman, Kenneh

doi:10.1097/00000542-198201000-00021

Cited by 28 publications

(15 citation statements)

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“…Other potential problems, such as compression peripheral neuropathy, spinal cord damage with paraplegia, and peripheral neuropathy, did not occur (16,29). There was also no spinal cord infarction, cervical myelopathy, macroglossia as a result of venous outflow obstruction, hypoxia, hypercapnia, or cardiac arrest (16,26).…”

Section: Resultsmentioning

confidence: 99%

“…Tension pneumocephalus may cause postoperative lethargy but is also reported in the literature as a potentially serious and life-threatening emergency (26). In 1 large study, it was described in association with posterior fossa exploration in the semisitting position, with an incidence of 3% of life-threatening cases (24).…”

Section: Other Risks Of the Semisitting Positionmentioning

confidence: 98%

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A Standardized Protocol for the Prevention of Clinically Relevant Venous Air Embolism During Neurosurgical Interventions in the Semisitting Position

et al. 2009

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Fear of massive venous air embolism is one reason for dramatic decline in the use of the semisitting position in neurosurgical practice. We found that strict adherence to a standardized protocol using TEE monitoring before and during surgery; exclusion of patients with patent foramen ovale; and a combination of positive end expiratory pressure, fluid input, and a standardized position aiming a positive pressure in the transverse and sigmoid sinuses helped to greatly minimize this complication to a rate of 0.5% for hemodynamically relevant events.

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Section: Resultsmentioning

confidence: 99%

Section: Other Risks Of the Semisitting Positionmentioning

confidence: 98%

A Standardized Protocol for the Prevention of Clinically Relevant Venous Air Embolism During Neurosurgical Interventions in the Semisitting Position

et al. 2009

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“…Tension pneumocephalus behaves in a similar way as an intracranial space-occupying lesion causing intracranial hypertension, potentially with ensuing downward herniation [41]. Air embolism and cardiac arrest are associated with pneumocephalus in rare circumstances [41,42].…”

Section: Complicationsmentioning

confidence: 99%

“…Air embolism and cardiac arrest are associated with pneumocephalus in rare circumstances [41,42]. Ascending meningitis has been described in the literature as a serious complication of unrepaired skull base defects in patients with CSF leaks, with an incidence of about 30% and a cumulative 10-year risk of 85% [43,44].…”

Section: Complicationsmentioning

confidence: 99%

Pneumocephalus: Case Illustrations and Review

2010

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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.

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“…2 Generally, the most common symptoms of tension pneumocephalus are altered consciousness, headache, generalized convulsions, or restlessness, 3 but even cardiac arrest caused by tension pneumocephalus. 4 The discrimination of tension and non-tension pneumocephalus is crucial to prevent serious conditions. …”

mentioning

confidence: 99%