Tension Pneumocephalus—A Rare Complication of Craniofacial Fracture: Report and Review

Sahoo, Nanda Kishore; Rangan, N. Mohan; Bajaj, Harish; Kumar, Rahul

doi:10.1007/s12663-017-1036-5

Cited by 5 publications

(5 citation statements)

References 21 publications

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“…Only a handful of case reports have described about the frontal sinus osteomyelitis following mucormycosis [8][9][10][11] . Mucormycosis usually affects the nose and paranasal sinuses; the disease can spread via direct extension or by hematogenous spread.…”

Section: Discussionmentioning

confidence: 99%

Fungal Osteomyelitis of Frontal Bone Following Covid Associated Mucormycosis

Mehta,

Rao,

Nagarkar

et al. 2024

Preprint

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Introduction - The second wave of COVID 19 lead to resurgence of opportunistic infections due to injudicious use of steroids. Sinonasal Mucormycosis was declared as an epidemic during the pandemic. The mucormycosis was managed effectively by surgical debridement along with systemic amphotericin B. Now, following the initial treatment of mucormycosis there is a resurgence, in the form of fungal osteomyelitis of the frontal bone. Methods – the prospective study included the cases from ten patients with fungal osteomyelitis of frontal bone due to mucormycosis, all the patients underwent surgical debridement of sequestrum and involucrum with systemic antifungals. Results - The average duration of the recurrence was 22 days following the initial treatment Range (10 days to 33 days). Extracranial bossing following outer frontal cortex erosion in 30% of cases, bicortical erosion in 30%, bifrontal involvement (20%), dural involvement (30%), brain parenchymal involvement and prefrontal cortex (20%) case. All cases underwent debridement of entire sequestrous bone and involucrum till normal bone was identified. The mean duration of admission was 4 weeks (3 to 6 weeks). All treated patients are currently alive without disease, confirmed by CECT. Conclusion - The successful treatment of fungal osteomyelitis due to mucormycosis requires four pronged approach (1) early detection (2) multidisciplinary management of comorbidities (3) surgical debridement of necrotic bone and (4) adequate systemic antifungal therapy. Long term outcomes of fungal osteomyelitis of frontal bone are yet to be established

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Section: Discussionmentioning

confidence: 99%

Fungal Osteomyelitis of Frontal Bone Following Covid Associated Mucormycosis

Mehta,

Rao,

Nagarkar

et al. 2024

Preprint

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“…Sahoo et al reported a case of isolated frontal sinus mucormycosis that was accessed by coronal approach and after debridement of necrotic tissue, pericranial osteoplastic flap was used for obliteration. [ 8 ] Isolated involvement presents with non-specific symptoms of frontal headache leading to late recognition and usually with orbital or intracranial complications as a first clinical sign. [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Isolated Frontal Sinus Mucormycosis Post Covid 19-external Approaches Revisited!

Arora¹,

Wadhera²,

Professor³

et al. 2023

Indian J Otolaryngol Head Neck Surg

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Background Isolated frontal sinus involvement in mucormycosis is seen very infrequently. Recent technological advances including image guided navigation and angled endoscopes have shifted paradigm towards minimally invasive surgeries. Open approaches are still relevant for the disease of frontal sinus with lateral extension where effective clearance cannot be obtained if approached endoscopically. Objectives The objective of this study was to describe the presentation and management of patients of mucormycosis with isolated frontal sinus involvement with help of external approaches. Materials and methods The available records of the patients were retrieved and analysed. The literature, the associated contributory clinical features and management techniques were reviewed. Results 4 patients presented with isolated frontal sinus mucor involvement. 3 out of 4 patients had history of diabetes mellitus (75%). All patients had history of covid-19 infection (100%). 3 out of 4 patients had unilateral frontal sinus involvement and were operated by Lynch Howarth approach. Mean age of presentation was 46 years with male predominance. Bicoronal approach was used in one case with bilateral involvement. Conclusion Although conservative endoscopic surgeries are preferred nowadays for frontal sinus clearance but the extensive bony destruction with lateral extension in our series of patients with isolated frontal sinus mucormycosis warranted the need for open procedures.

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“…Tension pneumocephalus is a potentially life-threatening complication that presents with nonspecific symptoms such as headache, coma, and hemiparalysis, alongside deteriorating GCS, and it requires emergent decompression [ 12 , 13 ]. A few theories that highlight the development of tension pneumocephalus include the “ball valve” theory of Dandy and the inverted bottle cap effect theory.…”

Section: Discussionmentioning

confidence: 99%

“…The inverted bottle cap theory postulates that trauma within the cranium leads to decreased intracranial pressure, resulting in a vacuum that causes an inflow of air [ 1 ]. Volume of as little as 6.5 ml of air has been demonstrated to be discernible enough to cause tension pneumocephalus [ 12 ]. The treatment of tension pneumocephalus arises from a timely recognition of its classic imaging phenomena, known as the “Mount Fuji” sign on a CT of the brain [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Delayed Postoperative Tension Pneumocephalus Treated With a Subdural Evacuating Port System: A Case Report and Review of the Literature

Laing¹,

Janardan²,

Shah³

et al. 2022

Cureus

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Tension pneumocephalus (TP) is a rare neurosurgical emergency due to the rise of intracranial pressure from air in the cranial cavity. Tension pneumocephalus' clinical presentation ranges from headache, visual alterations, altered mental status, and death. Given its nonspecific clinical presentation, tension pneumocephalus is usually diagnosed via computed tomography (CT) imaging. Open burr hole craniotomy is the preferred treatment method for tension pneumocephalus. Subdural evacuating port system (SEPS) drains have, however, seen increased utilization in neurosurgery due to decreased possibilities for infections, reduced seizure probability, and better outcomes post-surgery, especially for elderly patients.In this article, we present the case of a 67-year-old female with postoperative tension pneumocephalus after the evacuation of an acute subdural hematoma. The patient became symptomatic from tension pneumocephalus, which was evacuated using a subdural evacuating port system drain. Post-drain placement, the patient had a radiographic and clinical resolution of her tension pneumocephalus.The subdural evacuating port system is a useful adjunctive tool for treating tension pneumocephalus. Given the favorable characteristic profile of subdural evacuating port system drains compared to open surgical modalities, further inquiry should be pursued to analyze the feasibility of establishing subdural evacuating port systems as a less invasive treatment alternative.

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Tension Pneumocephalus—A Rare Complication of Craniofacial Fracture: Report and Review

Cited by 5 publications

References 21 publications

Fungal Osteomyelitis of Frontal Bone Following Covid Associated Mucormycosis

Fungal Osteomyelitis of Frontal Bone Following Covid Associated Mucormycosis

Isolated Frontal Sinus Mucormycosis Post Covid 19-external Approaches Revisited!

Delayed Postoperative Tension Pneumocephalus Treated With a Subdural Evacuating Port System: A Case Report and Review of the Literature

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