Pneumocephalus due to barotrauma: CT demonstration.

Hermans, P; Bracke, P.; Demeyer, I V

doi:10.2214/ajr.159.6.1442423

Cited by 18 publications

(13 citation statements)

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“…However, one has to keep in mind rare but more serious conditions, such as a pneumocephalus, when confronted with headache after diving. A rupture through the tegmen tympani of the temporal bone after middle-ear barotrauma has been reported (2)(3)(4). In an autopsy study, a defect in the tegmen tympani was found in 52% of routine cases (5), so this could be a breakthrough of air through soft tissues.…”

Section: Discussionmentioning

confidence: 99%

Sphenoid sinus barotrauma with intracranial air in sella turcica after diving

et al. 2006

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Section: Discussionmentioning

confidence: 99%

Sphenoid sinus barotrauma with intracranial air in sella turcica after diving

et al. 2006

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“…4 There are also rare reports of pneumocephalus resulting from barotraumas in a pilot and scuba divers. 5,6 In our patient, two possible mechanisms could be suggested for the development of pneumocephalus. The first mechanism was fronto-basal fracture and the second mechanism was craniofacial surgery.…”

Section: Discussionmentioning

confidence: 64%

Is Fluoroscopy-Guided Drainage of Tension Pneumocephalus an Appropriate Intervention?: Surgical Technique

Demir¹,

Deniz²,

Öksüz³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T Tension pneumocephalus is not a common entity after head trauma. It requires urgent intervention when associated with raised intracranial pressure. A 22 year-old man was admitted in our emergency unit after being involved in a traffic accident. Initial assessment of the patient revealed a Gloskow Coma Score (GCS) of 8. Radiological exams showed left fronto-orbital depression fracture, left fronto-basal fracture and left frontal cerebral contusion. The patient was operated urgently. Depressed bones were elevated and cranial reconstruction was done. After the initial operation, his neurological level elevated day by day. Thirty days after the operation computed tomography (CT) scan showed left frontal pneumocephalus. Conservative treatment was initiated. First, the volume of air in the field decreased spontaneously but after strong coughing, the amount of air increased and showed resistance to absorption. The patient was reoperated. Left frontal pneumatic space was irrigated with physiologic saline until all air was evacuated. Fluoroscopy showed the location of the intracranial air and no air was left after evacuation. The patient recovered well. No intracranial air was detected in his follow-up. There is no standard surgical intervention for tension pneumocephalus. Fluoroscopy-guided drainage with punctuation needle for tension pneumocephalus is a minimally invasive and effective procedure.K Ke ey y W Wo or rd ds s: : Tension pneumocephalus; head trauma; surgical treatment Ö ÖZ ZE ET T Tansiyon pnömosefali, kafa travmalarından sonra sık görülen bir durum değildir. İntrakra-niyal basınçta artışa neden olduğunda acil müdahale gerektirir. Yirmi iki yaşında bir erkek hasta, trafik kazası geçirdikten sonrası acil servisimize başvurdu. Hastanın ilk nörolojik muayenesinde Glasgow Koma Skoru (GKS) 8 bulundu. Radyolojik çalışmalar, sol fronto-orbital çökme kırığı, sol frontobazal kırık ve sol frontal serebral kontüzyon olduğunu gösterdi. Hasta acilen ameliyat edildi. Operasyonda çökmüş kemikler kaldırıldı ve kraniyal rekonstrüksiyon yapıldı. İlk operasyondan sonra hastanın kliniği günden güne düzeldi. Otuz gün sonra hastaya çekilen bilgisayarlı tomografi (BT) incelemesinde sol frontal pnömosefali tespit edildi. Öncelikle hastaya konservatif tedavi başlandı. Önce alandaki hava miktarı spontan olarak azaldı. Fakat hastanın güçlü öksürmesinin ardın-dan, alandaki hava miktarı arttı ve absorbe olmadı. Hasta bunun üzerine tekrar operasyona alındı. Operasyonda sol frontal bölgedeki hava serum fizyolojik ile irrigasyonla boşaltıldı. Floroskopi intrakraniyal havanın lokalizasyonunu ve drenaj işlemi sonrasında da bölgede havanın kalmadığını gösterdi. Hasta iyileşti. Hastanın takiplerinde de intrakraniyal hava tespit edilmedi. Tansiyon pnö-mosefali için standart bir tedavi yöntemi yoktur. Tansiyon pnömosefalide floroskopi yardımlı ponksiyon iğnesiyle havanın drenajı, invaziv olmayan etkili bir yöntemdir.A An na ah ht ta ar r K Ke el li im me el le er r: : Tansiyon pnömosefali; kafa travması; cerrahi tedavi T...

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“…Other causes include tumours, nasogastric tube insertion, bag-mask ventilation, nasotracheal intubation, use of continuous positive airways pressure in patients with head and facial injuries, transphenoidal surgery [7], insertion of a shunt [8], epidural and spinal anaesthesia, lumbar puncture, nitrous oxide anaesthesia and chronic otitis media [1,6,9]. The three previous reports of barotrauma causing pneumocephalus, which were in young adults, occurred in a pilot while flying and in two divers during rapid ascent [6,9,10].…”

Section: Discussionmentioning

confidence: 99%

Case report. Acute confusion secondary to pneumocephalus in an elderly patient

Chan

Yau²,

Lewis³

et al. 2000

Age and Ageing

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Presentation: an 83-year-old man was admitted to hospital with acute confusion 3 days after a direct flight from Australia. Outcome: computed tomography (CT) brain scan and magnetic resonance imaging head scan revealed the cause to be pneumocephalus, apparently the result of barotrauma caused by Valsalva manoeuvres when he attempted to unblock his nose during the flight. After 5 days of nursing in the vertical position the patient's Abbreviated Mental Score returned to normal. A CT brain scan 6 weeks later showed complete resolution of the pneumocephalus.

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Pneumocephalus due to barotrauma: CT demonstration.

Cited by 18 publications

References 0 publications

Sphenoid sinus barotrauma with intracranial air in sella turcica after diving

Sphenoid sinus barotrauma with intracranial air in sella turcica after diving

Is Fluoroscopy-Guided Drainage of Tension Pneumocephalus an Appropriate Intervention?: Surgical Technique

Case report. Acute confusion secondary to pneumocephalus in an elderly patient

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