Abstract
Background: Pneumocephalus is commonly encountered after neurosurgical procedures but can also be caused by craniofacial trauma and tumors of the skull base and rarely, can occur spontaneously. Contributing factors for the development of pneumocephalus include head position, duration of surgery, nitrous oxide (N2O) anesthesia, hydrocephalus, intraoperative osmotherapy, hyperventilation, spinal anesthesia, barotauma, continuous CSF drainage via lumbar drain, epidural anesthesia, infections, and neoplasms. Clinical presentation includes headaches, nausea and vomiting, seizures, dizziness, and depressed neurological status. In this article, we review the incidence, mechanisms, precipitating factors, diagnosis, and management of pneumocephalus. Search of Medline, databases, and manual review of article bibliographies. Considering four case illustrations that typify pneumocephalus in clinical practice, we discuss the common etiologies, and confirm the diagnosis with neuroimaging and management strategies. Avoidance of contributing factors, high index of suspicion, and confirmation with neuroimaging are important in attenuating mortality and morbidity. A significant amount of pneumocephalus can simulate a space-occupying lesion. Supplemental oxygen increases the rate of absorption of pneumocephalus.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 152-158 |
| Number of pages | 7 |
| Journal | Neurocritical Care |
| Volume | 13 |
| Issue number | 1 |
| DOIs | |
| State | Published - Aug 2010 |
| Externally published | Yes |
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Keywords
- Air bubble sign
- Mount Fuji sign
- Nitrous oxide
- Pneumocephalus
- Postsurgical
ASJC Scopus subject areas
- Clinical Neurology
- Critical Care and Intensive Care Medicine
- Medicine(all)
Cite this
Pneumocephalus : Case illustrations and review. / Schirmer, Clemens M.; Heilman, Carl B.; Bhardwaj, Anish.
In: Neurocritical Care, Vol. 13, No. 1, 08.2010, p. 152-158.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Pneumocephalus
T2 - Case illustrations and review
AU - Schirmer, Clemens M.
AU - Heilman, Carl B.
AU - Bhardwaj, Anish
PY - 2010/8
Y1 - 2010/8
N2 - Background: Pneumocephalus is commonly encountered after neurosurgical procedures but can also be caused by craniofacial trauma and tumors of the skull base and rarely, can occur spontaneously. Contributing factors for the development of pneumocephalus include head position, duration of surgery, nitrous oxide (N2O) anesthesia, hydrocephalus, intraoperative osmotherapy, hyperventilation, spinal anesthesia, barotauma, continuous CSF drainage via lumbar drain, epidural anesthesia, infections, and neoplasms. Clinical presentation includes headaches, nausea and vomiting, seizures, dizziness, and depressed neurological status. In this article, we review the incidence, mechanisms, precipitating factors, diagnosis, and management of pneumocephalus. Search of Medline, databases, and manual review of article bibliographies. Considering four case illustrations that typify pneumocephalus in clinical practice, we discuss the common etiologies, and confirm the diagnosis with neuroimaging and management strategies. Avoidance of contributing factors, high index of suspicion, and confirmation with neuroimaging are important in attenuating mortality and morbidity. A significant amount of pneumocephalus can simulate a space-occupying lesion. Supplemental oxygen increases the rate of absorption of pneumocephalus.
AB - Background: Pneumocephalus is commonly encountered after neurosurgical procedures but can also be caused by craniofacial trauma and tumors of the skull base and rarely, can occur spontaneously. Contributing factors for the development of pneumocephalus include head position, duration of surgery, nitrous oxide (N2O) anesthesia, hydrocephalus, intraoperative osmotherapy, hyperventilation, spinal anesthesia, barotauma, continuous CSF drainage via lumbar drain, epidural anesthesia, infections, and neoplasms. Clinical presentation includes headaches, nausea and vomiting, seizures, dizziness, and depressed neurological status. In this article, we review the incidence, mechanisms, precipitating factors, diagnosis, and management of pneumocephalus. Search of Medline, databases, and manual review of article bibliographies. Considering four case illustrations that typify pneumocephalus in clinical practice, we discuss the common etiologies, and confirm the diagnosis with neuroimaging and management strategies. Avoidance of contributing factors, high index of suspicion, and confirmation with neuroimaging are important in attenuating mortality and morbidity. A significant amount of pneumocephalus can simulate a space-occupying lesion. Supplemental oxygen increases the rate of absorption of pneumocephalus.
KW - Air bubble sign
KW - Mount Fuji sign
KW - Nitrous oxide
KW - Pneumocephalus
KW - Postsurgical
UR - http://www.scopus.com/inward/record.url?scp=77954384549&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77954384549&partnerID=8YFLogxK
U2 - 10.1007/s12028-010-9363-0
DO - 10.1007/s12028-010-9363-0
M3 - Article
C2 - 20405340
AN - SCOPUS:77954384549
VL - 13
SP - 152
EP - 158
JO - Neurocritical Care
JF - Neurocritical Care
SN - 1541-6933
IS - 1
ER -