Download PDF
J Neurol Surg A Cent Eur Neurosurg 2020; 81(06): 575-578
DOI: 10.1055/s-0040-1713798
Case Report

Spontaneous Intraparenchymal Tension Pneumocephalus

Hyukjoon Seo
1   Department of Neurosurgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
,
Sang Hoon Kim
2   Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
,
Jiwook Ryu
1   Department of Neurosurgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
,
Sung Ho Lee
3   Department of Neurosurgery, College of Medicine, Seoul National University, Seoul, Republic of Korea
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Tension pneumocephalus is a treatable emergency that is usually caused by trauma or surgery. We present a rare case of spontaneous tension pneumocephalus. A 64-year-old woman presented with a severe aggravating headache. Computed tomography revealed a large air collection in the brain parenchyma of the right frontal lobe, both lateral ventricles, and the subarachnoid space. Emergent craniotomy was performed because her headache got progressively worse. We found that an abnormal bony protrusion connected the frontal sinus mucosa and the intraparenchymal pneumocephalus. After removal of the bony mass and repair of the defect, the patient immediately recovered and there was no recurrence.

Keywords

brain - pneumocephalus - surgery

Informed Consent

Informed consent was obtained from all individual participants included in the study.




Publication History

Received: 20 November 2019

Accepted: 13 February 2020

Article published online:
10 September 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 Demetriades AK, Bhangoo RS, Bassi S. Severe traumatic pneumocephalus in association with epistaxis: the “twin peaks” sign. Acta Neurochir (Wien) 2011; 153 (05) 1151-1152 , discussion 1152
    CrossrefPubMedGoogle Scholar
  • 2 Heckmann JG, Ganslandt O. Images in clinical medicine. The Mount Fuji sign. N Engl J Med 2004; 350 (18) 1881
    CrossrefPubMedGoogle Scholar
  • 3 Lee SH, Koh JS, Bang JS, Kim MC. Extensive tension pneumocephalus caused by spinal tapping in a patient with Basal skull fracture and pneumothorax. J Korean Neurosurg Soc 2009; 45 (05) 318-321
    CrossrefPubMedGoogle Scholar
  • 4 Markham JW. The clinical features of pneumocephalus based upon a survey of 284 cases with report of 11 additional cases. Acta Neurochir (Wien) 1967; 16 (01) 1-78
    CrossrefPubMedGoogle Scholar
  • 5 Johnson D, Tan L. Intraparenchymal tension pneumatocele complicating frontal sinus osteoma: case report. Neurosurgery 2002; 50 (04) 878-879 , discussion 880
    CrossrefPubMedGoogle Scholar
  • 6 Horowitz M. Intracranial Pneumocoele. An unusual complication following mastoid surgery. J Laryngol Otol 1964; 78: 128-134
    CrossrefPubMedGoogle Scholar
  • 7 Emmez H, Durdag E, Uslu S, Pasaoglu A, Ceviker N. Intracerebral tension pneumocephalus complicating endoscopic sinus surgery: case report. Acta Neurochir (Wien) 2009; 151 (08) 1001-1002
    CrossrefPubMedGoogle Scholar