Abstract
A child is described in whom intraventricular tension pneumocephalus developed 10 days after removal of a cerebellar medulloblastoma and 1 day after suture removal. The tension pneumocephalus was associated with hydrocephalus and CSF leakage from the suture line. The symptoms of the pneumocephalus were rapidly progressing loss of consciousness and hemiplegia which were promptly reversed upon aspiration of the intracranial air. A large amount of intraventricular air present in the immediate postoperative period was, however, clinically silent. The characteristics of this unusual presentation, its relation to asymptomatic pneumocephalus. hydrocephalus and the preventive and therapeutic measures required to deal with such conditions are discussed.
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Black PM, Davis JM, Kjellberg RN (1979) Tension pneumocephalus of the cranial subdural space: a case report. Neurosurgery 5:368–370
Bremer AM, Nguyen TQ (1982) Tension pneumocephalus after surgical treatment of chronic subdural hematoma: report of three cases. Neurosurgery 2:284–287
Briggs M (1974) Traumatic pneumocephalus. Br J Surg 61:307–312
Dandy WE (1926) Pneumocephalus (intracranial pneumotocele or aerocele). Arch Surg 12:949–982
Findler G, Hoffman HJ, Munro IR (1980) Tension pneumocephalus complicating craniofacial surgery in a shunted hydrocephalic patient: case report. Neurosurgery 7:525–528
Grundy BL, Spetzler RF (1980) Subdural pneumocephalus resulting form drainage of cerebrospinal fluid during craniotomy. Anesthesiology 52:269–271
Healy JF, Wells MU, Rosenkrantz H (1980) Tension pneumocephalus. J Comput Assist Tomogr 4:247–250
Ikeda K, Nakano M, Tani E (1978) Tension pneumocephalus complicating ventriculoperitoneal shunt for cerebrospinal fluid rhinorrhoca: case report. J Neurol Neurosurg Psychiatry 41:319–322
Kitahata LM, Katz JD (1976) Tension pneumocephalus after posterior fossa craniotomy, a complication of the sitting position. Anesthesiology 44:448–450
Little JR, McCarty CS (1976) Tension pneumophalus after insertion of ventriculoperitoneal shunt for aqueductal stenosis: case report. J Neurosurg 44:383–385
Lunsford LD, Maroon JC, Sheptak PE, Albin MS (1979) Subdural tension pneumocephalus: report of two cases. J Neurosurg 50:525–527
Magnaes B, Nornes H (1972) Traumatic tension pneumohydrocephalus. The intracranial pressure pattern and the pathogenetic factors. Acta neurochir (Wien) 27:17–27
Markham JW (1967) The clinical features of pneumocephalus based upon a survey of 284 cases with report of 11 additional cases. Acta Neurochir (Wien) 16:1–78
Markham JW (1976) Pneumocephalus. In: Vinken PJ, Bruyn GW (eds) Injuries of the brain and skull. (Handbook of clinical neurology, vol 24) Elseyier, New York, pp 201–213
Michaelsson E (1943) Pneumocephalus: report of a surgical case. Acta Chir Scand 89:81–88
Monajati A, Cotanch WW (1982) Subdural tension pneumocephalus following surgery. J Comput Assist Tomogr 6:902–906
Muizelaar JP, Walder H (1976) Tension pneumocephalus following insertion of ventriculoatrial shunt after severe head trauma: case report. Clin Neurol Neurosurg 80:57–61
North JB (1971) On the importance of intracranial air. Br J Surg 58:826–829
Pitts LH, Wilson CB, Dedo HH (1975) Pneumocephalus following ventriculoperitoneal shunt: case report. J Neurosurg 43:631–633
Pop PM, Thompson JR, Zinke DE (1982) Tension pneumocephalus. J Comput Assist Tomogr 6:894–901
Ramsden RT, Block J (1976) Traumatic pneumocephalus. J Laryngol Otol 90:345–355
Rand CW (1930) Taumatic pneumocephalus: report of eight cases. Arch Surg 20:935–958
Toung T, Douham RT, Lehrer A, (1983) Tension pneumocephalus after posterior fossa craniotomy: report of four additional cases and review of postoperative pneumocephalus. Neurosurgery 12:164–168
Waring GO III, Flanagan JC (1975) Pneumocephalus: a sign of intracranial involvement in orbital fracture. Arch Ophthalmol 92:847–850
Witcombe JB, Torrens MJ, Gye RS (1976) Intracerebral pneumatocele: an unusual complication following intraventricular drainage in a case of benign intracranial hypertension. Neuroradiology 12:161–163
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Ram, Z., Knoller, N., Findler, G. et al. Delayed intraventricular tension pneumocephalus complicating posterior fossa surgery for cerebellar medulloblastoma. Child's Nerv Syst 8, 351–353 (1992). https://doi.org/10.1007/BF00296568
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DOI: https://doi.org/10.1007/BF00296568