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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2018; 79(04): e88-e92
DOI: 10.1055/s-0038-1676298
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Tension Pneumocephalus after Cervical Spine Surgery: A Case Report with Review of the Literature

Jeremiah Maupin
1   Department of Orthopaedic Surgery and Rehabilitation, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Zackary Burrow
1   Department of Orthopaedic Surgery and Rehabilitation, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Cameron Shirazi
1   Department of Orthopaedic Surgery and Rehabilitation, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Santaram Vallurupalli
1   Department of Orthopaedic Surgery and Rehabilitation, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
› Author Affiliations
Further Information

Publication History

14 August 2018

16 October 2018

Publication Date:
30 November 2018 (online)

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Abstract

This is the case of a 66-year-old male with cervical myelopathy secondary to severe cervical stenosis manifesting as worsening dexterity and numbness in his right hand. The patient underwent C3–C6 laminoplasty with bilateral foraminotomies. During the procedure an incidental durotomy occurred which was patched intraoperatively with Duragen and Tisseel. At 1 month follow-up, the patient reported that he was doing well and skin sutures were removed. Two days later, the patient presented to the emergency department with postoperative wound dehiscence, cerebrospinal fluid (CSF) drainage, altered mental status and lethargy. At that time, a computed tomography (CT) scan confirmed a tension pneumocephalus which was treated with a cranial burr hole and revision durotomy repair. The patient improved and was discharged to a rehabilitation facility with intact motor and cognitive function. At the 1-year follow-up appointment, he continued to do well without sequelae.

Keywords

tension pneumocephalus - dural tear - durotomy

Disclosures

Each author certifies that he or she, or a member of his or her immediate family, has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with this submitted article.


This case report has been created in accordance with the ethical principles of research. Patient consent has been obtained for publication of this case and use of imaging.