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  3. 卷 9 编号 1 (2021): Continuous volume
  4. Case Report

卷 9 编号 1 (2021)

一月 2021

Delayed post-traumatic Tension Hydropneumocephalus; a Case Report of Conservative Treatment

  • Talayeh Mirkarimi
  • Mohammad Salek
  • Ehsan Modirian
  • Peyman namdar

学术急诊医学档案, 卷 9 编号 1 (2021), 1 一月 2021 , 第 e22 页
https://doi.org/10.22037/aaem.v9i1.1172 已出版: 2021-02-27

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摘要

Pneumocephalus refers to the presence of air in the cranial cavity. Trauma is the most common cause of acquired pneumocephalus. Tension pneumocephalus occurs when intracranial accumulation of air causes high pressure on the brain as compared to extracranial pressure. Tension pneumocephalus is usually acute, and causes neurological symptoms, and its delayed form rarely occurs. A 12-year-old girl presented with a headache, lethargy, mild fever, and nausea from two days before admission to emergency department of Shahid Rajaei Hospital, Qazvin, Iran. The patient had a history of head trauma in a driving accident six weeks before and had undergone brain computed tomography (CT) scan in another centre, which had revealed no sign of pneumocephalus. The patient had been treated for one week and had been discharged in good general condition.

Considering her reduced consciousness, the patient underwent brain CT scan again in our centre. CT scan revealed tension hydropneumocephalus. The patient was transferred to the intensive care unit (ICU) for treatment. Considering the trend of her recovery, the patient was a candidate for conservative non-surgical therapy based on the in-charge neurosurgery specialist’s decision. The patient reported no complications during the six-month follow-up. Delayed tension pneumocephalus is among neurosurgery emergencies usually treated with early surgical intervention and dura defect restoration, but this patient received non-surgical treatment without any serious problem during the six-month follow-up.

关键词:
  • Pneumocephalus
  • Craniocerebral Trauma
  • Conservative Treatment
  • Case Reports
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Mirkarimi T, Salek M, Modirian E, namdar P. Delayed post-traumatic Tension Hydropneumocephalus; a Case Report of Conservative Treatment . Arch Acad Emerg Med [网际网络]. 2021年2月27日 [见引于 2026年7月26日];9(1):e22. 载于: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/1172
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参考

Chhiber SS, Nizami FA, Kirmani AR, Wani MA, Bhat AR, Zargar J, et al. Delayed posttraumatic intraventricular tension pneumocephalus: Case report. Neurosurgery Quarterly. 2011;21(2):128-32.

Leong K, Vijayananthan A, Sia S, Waran V. Pneumocephalus: an uncommon finding in trauma. The Medical journal of Malaysia. 2008;63(3):256-8.

Kankane VK, Jaiswal G, Gupta TK. Posttraumatic delayed tension pneumocephalus: Rare case with review of literature. Asian journal of neurosurgery. 2016;11(4):343.

Solomiichuk VO, Lebed VO, Drizhdov KI. Posttraumatic delayed subdural tension pneumocephalus. Surgical neurology international. 2013;4.

Dabdoub CB, Salas G, Silveira EdN, Dabdoub CF. Review of the management of pneumocephalus. Surgical Neurology International. 2015;6.

Ihab Z. Pneumocephalus after surgical evacuation of chronic subdural hematoma: Is it a serious complication? Asian journal of neurosurgery. 2012;7(2):66.

Pillai P, Sharma R, MacKenzie L, Reilly EF, Beery PR. Traumatic tension pneumocephalus–Two cases and comprehensive review of literature. International journal of critical illness and injury science. 2017;7(1):58.

Wang A, Solli E, Carberry N, Hillard V, Tandon A. Delayed tension pneumocephalus following gunshot wound to the head: a case report and review of the literature. Case reports in surgery. 2016;2016.

Komolafe E, Faniran E. Tension pneumocephalus-a rare but treatable cause of rapid neurological deterioration in traumatic brain injury. A case report. African Journal of Neurological Sciences. 2010;29(2):88-91.

Horowitz M. Intracranial pneumocoele: An unusual complication following mastoid surgery. The Journal of Laryngology & Otology. 1964;78(2):128-34.

Aydoseli A, Akcakaya MO, Aras Y, Boyali O, Unal OF. Emergency management of an acute tension pneumocephalus following ventriculoperitoneal shunt surgery for normal pressure hydrocephalus. Turkish neurosurgery. 2013;23(4):564-7.

Almezeiny TA, Almarshad MA. Delayed Posttraumatic Tension Pneumocephalus: A Rare Case Report and Review of the Literature. Dr Sulaiman Al Habib Medical Journal. 2020;2(1):1-3.

Kuncz A, Roos A, Lujber L, Haas D, Al Refai M. Traumatic prepontine tension pneumocephalus--case report. Ideggyogyaszati szemle. 2004;57(9-10):313-5.

Michel SJ. The mount fuji sign. Radiology. 2004;232(2):449-50.

Atalar MH. Mount Fuji sign in tension pneumocephalus. Journal of Emergency Medicine Case Reports. 2009;4(3):121-2.

Rao V, Fredriksli O, Gulati S. Post-traumatic epidural tension pneumocephalus: a case report. Journal of medical case reports. 2015;9(1):1-4.

Kumanan T, Sujanitha V, Suganthan N. Tension hydropneumocephalus. 2018.

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