Rare incidence of tension pneumocephalus 2 months after repeat microvascular decompression

xlomafota13 shared this article with you from Inoreader Rare incidence of tension pneumocephalus 2 months after repeat microvascular decompression Via leak of cerebrospinal fluid Surg Neurol Int. 2021 Jun 28;12:311. doi: 10.25259/SNI_917_2020. eCollection 2021. ABSTRACT BACKGROUND: Tension pneumocephalus is a rare complication after intracranial procedures and craniotomy. We report a rare case of intraventricular and subdural tension pneumocephalus occurring 2 months after repeat right-sided microvascular decompression (MVD) for recurrent trigeminal neuralgia. CASE DESCRIPTION: The patient in this case was a 79-year-old woman who presented with acute-onset confusion, headaches, nausea, and vomiting. On computed tomography, substantial volumes of pneumocephalus in the fourth ventricle and subdural space at the site of the retrosigmoid exposure for the previous MVD were seen. She underwent emergent wound exploration, and no obvious dural defect or exposed mastoid air cells were identified. The dura was reopened, and the surgical site was copiously irrigated. Mastoid air cells were covered with ample amounts of bon e wax, and the wound was closed. The patient recovered well postoperatively with complete resolution of the pneumocephalus by her 3-month follow-up evaluation. CONCLUSION: It is important to assess for cerebrospinal fluid leakage and that air cells are sealed off before wound closure to prevent a pathway for air to egress into the surgical cavity and corridor. PMID:34345452 | PMC:PMC8326134 | DOI:10.25259/SNI_917_2020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.