Delayed Posttraumatic Tension Pneumocephalus: A Rare Case Report and Review of the Literature

DOI

10.2991/dsahmj.k.200316.001How to use a DOI?

Keywords

Tension pneumocephalus; traumatic pneumocephalus; cerebrospinal fluid leak; craniotomy; rhinorrhea; head trauma; frontal bone; frontal sinus; dura

Abstract

Pneumocephalus (PNC) is defined as a pathological air collection inside the skull in the epidural, subdural, subarachnoid, intraventricular, or intraparenchymal compartments. The rate at which the air accumulates inside the cranium could be acute (<72 h) or delayed (≥72 h). Tension PNC (TP) occurs when the air collection exerts an abnormally high pressure on the brain, compared with the pressure outside the cranium, resulting in a mass effect and neurological symptoms. PNC, also called pneumocranium, can be spontaneous or acquired. Trauma remains the most common cause of acquired PNC. A 34-year-old gentleman presented with a short duration history of sudden severe headache, vomiting, and clear fluid leak from the left nostril. He had history of trauma, which occurred 3 months ago. Computed Axial Tomography (CAT) scan revealed intra-axial and extra-axial PNC plus an old depressed fracture of the left side of the frontal bone. Eventually, he was scheduled for surgical bifrontal craniotomy, repair of posterior sinus fracture, and recanalization of frontal sinus. Delayed TP is a rarely occurring pathology, and in rare cases it can occur many weeks after trauma. It is a life-threatening neurosurgical emergency that needs to be managed on urgent basis. Based on the literature review and the success achieved in this case, early surgical management is the optimal treatment for TP.

Copyright

© 2020 Dr. Sulaiman Al Habib Medical Group. Publishing services by Atlantis Press International B.V.

Open Access

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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TY  - JOUR
AU  - Tawfiq Abdulmohsen Almezeiny
AU  - Mody Abdulrahman Almarshad
PY  - 2020
DA  - 2020/03/19
TI  - Delayed Posttraumatic Tension Pneumocephalus: A Rare Case Report and Review of the Literature
JO  - Dr. Sulaiman Al Habib Medical Journal
SP  - 1
EP  - 3
VL  - 2
IS  - 1
SN  - 2590-3349
UR  - https://doi.org/10.2991/dsahmj.k.200316.001
DO  - 10.2991/dsahmj.k.200316.001
ID  - Almezeiny2020
ER  -