Intraventricular tension pneumocephalus and cervical subarachnoid pneumorrhachis in a bull mastiff dog after craniotomy

Abstract

An eight-year-old bull mastiff dog underwent a craniotomy for surgical excision of an olfactory lobe meningioma. Rapidly progressive neurological deficits with cervical pain developed within the early postoperative period. Intraventricular and cervical subarachnoid space air accumulation (pneumorrhachis) was identified through magnetic resonance imaging and computed tomography. Repair of a dural defect using synthetic dura substitute resulted in gradual resolution of neurological signs attributable to the tension pneumocephalus and subarachnoid space pneumorrhachis. Regrowth of the meningioma was not observed. Postoperative intraventricular tension pneumocephalus and air accumulation within subarachnoid space are uncommon but life-threatening complications of intracranial surgery. Early diagnosis and treatment can result in a satisfactory outcome.

Traumatic pneumocephalus in a dog

“…2 Keeping the patient' s head in a slightly lowered position is theorized to reduce CSF drainage, which may decrease continued gas trapping. In humans, clinical signs typically develop within 1 month after an injury, 6 with drowsiness, headache, and vomiting being the earliest signs. 2 Decompression can be achieved via needle aspiration, ventricular puncture, or catheter drainage.…”

Postoperative symptomatic haematoma and pneumorrhachis in a dog with a thoracolumbar intervertebral disc extrusion

“…Several underlying aetiologies have been suggested, with most cases occurring secondary to trauma or degenerative disc disease. Other causes include iatrogenic, infectious, spontaneous or toxic conditions and decompression sickness . Iatrogenic PR is reported secondary to epidural analgesia, thoracostomy tube placement, spinal surgery and radiation therapy .…”

“…In veterinary medicine, a case of spontaneous thoracic PR and a case of PR in conjunction with tension pneumocephalus after a transfrontal craniotomy or rhinotomy have been described . To the best of our knowledge, this is the first report describing the development of postoperative PR after a hemilaminectomy for a thoracolumbar intervertebral disc extrusion in a dog.…”

“…Other causes include iatrogenic, infectious, spontaneous or toxic conditions and decompression sickness. [1][2][3][4][5] Iatrogenic PR is reported secondary to epidural analgesia, thoracostomy tube placement, spinal surgery and radiation therapy. 2,6 Spontaneous PR denotes the occurrence of non-traumatic, non-iatrogenic gas within the vertebral canal.…”

Penetrating cranial injury due to gunshot in a dog: a case report

“…The complications caused by craniectomy generally include uncontrolled cerebral swelling, deterioration of neurological signs, an increase in ICP, seizures, cerebral herniation, hemorrhage, infection, pneumocephalus, and pneumonia (Cavanaugh et al, 2008;Jadhav and Zhang, 2008).…”