1/62. Intracerebral pneumatocele: an unusual complication following intraventricular drainage in case of benign intracranial hypertension.The development of an intracerebral pneumatocele following ventricular catheterization for benign intracranial hypertension is described. The importance of skull radiography in the diagnosis of this previously unreported complication ist emphasized. This case demonstrates that air can accumulate without the need to implicate increased pharyngeal pressure, and despite raised intracranial pressure.- - - - - - - - - - ranking = 1keywords = intracerebral, cerebral (Clic here for more details about this article) |
2/62. Pneumoencephalus and convulsions after ventriculoscopy: a potentially catastrophic complication.A nine-year-old boy with hydrocephalus underwent ventriculoscopy under general anesthesia. After introduction of ventriculoscope the patient had sudden bradycardia, hypotension, and shrinkage of ipsilateral cerebral hemisphere. The ventriculostomy was abandoned. At the end of anesthesia and endotracheal extubation, the patient developed generalized convulsions. Reexploration of wound did not reveal anything significant; however, postoperative CT scan of head showed massive pneumoencephalus. The patients received elective ventilation of lungs for 24 hours and made complete recovery. The authors describe the reasons for these complications and further management.- - - - - - - - - - ranking = 0.044355387454226keywords = cerebral (Clic here for more details about this article) |
3/62. Subdural air limits the elicitation of compound muscle action potentials by high-frequency transcranial electrical stimulation.High-frequency transcranial electrical stimulation was performed in 8 patients undergoing surgery in the sitting position. Following the opening of the dura of the posterior fossa changes in compound muscle action potentials were observed. These changes were not attributable to surgical manoeuvres at the brain stem or spinal cord, or to anaesthetic changes. In all these cases intraoperative fluoroscopy of the skull revealed a subdural air collection underneath the stimulation electrodes. Such a subdural air collection, not infrequent in patients operated on in the sitting position, limits the application of high-frequency transcranial electrical stimulation as a monitoring technique. It remains unclear if this effect is due to the increasing distance between scalp and cortex and the insulating effect of subdural air, or due to displacement of the motor cortex. The practical importance of this report is derived from the increasing application of intraoperative motor pathway monitoring.- - - - - - - - - - ranking = 0.0064835864274514keywords = brain (Clic here for more details about this article) |
4/62. Acute confusion secondary to pneumocephalus in an elderly patient.PRESENTATION: an 83-year-old man was admitted to hospital with acute confusion 3 days after a direct flight from australia. OUTCOME: computed tomography (CT) brain scan and magnetic resonance imaging head scan revealed the cause to be pneumocephalus, apparently the result of barotrauma caused by Valsalva manoeuvres when he attempted to unblock his nose during the flight. After 5 days of nursing in the vertical position the patient's Abbreviated Mental Score returned to normal. A CT brain scan 6 weeks later showed complete resolution of the pneumocephalus.- - - - - - - - - - ranking = 0.012967172854903keywords = brain (Clic here for more details about this article) |
5/62. Fatal posterior fossa pneumocephalus due to hydrogen peroxide irrigation of lumbar wound.Fatal brain stem failure developed suddenly in a 40-year-old male undergoing irrigation of an infected wound consequent to lumbar disc space infection. CT of head revealed posterior fossa pneumacephalus compressing the brain stem, which most likely developed from ingress of nascent oxygen under pressure through a defect in the thecal sac.- - - - - - - - - - ranking = 0.012967172854903keywords = brain (Clic here for more details about this article) |
6/62. pneumocephalus secondary to a neck stab wound without neurologic injury in a 13-year-old girl.pneumocephalus is usually caused by injury that damages the brain meninges and thus allows air to enter the intracranial cavity. Our intention was to establish the importance of considering a stab wound in the neck as a possible cause of traumatic pneumocephalus. The paper presents the case of a 13-year-old girl who was accidentally stabbed in the neck with a kitchen knife by her brother. She had no neurological deficit but had developed headaches. An examination showed cerebrospinal fluid leaking from the neck wound and a CT scan revealed the pneumocephalus. Following surgical treatment, the patient's clinical symptoms regressed. To our knowledge, this case is the first report of the manifestation of pneumocephalus as the result of a neck stab wound in a child; overall, there are only three reported cases of pneumocephalus caused by a neck stab wound.- - - - - - - - - - ranking = 0.0064835864274514keywords = brain (Clic here for more details about this article) |
7/62. A rare clival and sellar fracture with pneumatocephalus.We present a case of clival and sellar complex fracture produced by an indirect mechanism. This previously healthy patient had an occipital trauma followed by epistaxis. CT showed a clival and sellar fracture with pneumatocephalus. The probable fracture mechanism was contre-coup injury, linked to cerebral shock-wave transmission. This type of fracture is generally observed in the anterior part of the skull base, in a low resistance area. Severe osteoporosis probably accounted for the unusual fracture site in this patient. A mechanism of direct clival transmission is discussed, together with the usual complications of sphenoid injuries.- - - - - - - - - - ranking = 0.044355387454226keywords = cerebral (Clic here for more details about this article) |
8/62. Chronic subdural hematoma after transsphenoidal surgery.Chronic subdural haematoma has not been reported as a complication of transsphenoidal surgery. We present a case of pituitary adenoma which was gross-totally removed by transsphenoidal surgery with the enlarged sellar opening. Postoperative serial imaging showed massive air accumulation in both frontal subdural spaces followed by subdural fluid collection and subsequent chronic subdural haematomas 2 months later. We conclude that close follow up imaging study is required to avoid overlooking chronic subdural haematoma when massive air is introduced into the subdural space by the transsphenoidal surgery.- - - - - - - - - - ranking = 0.11317847379443keywords = haematoma (Clic here for more details about this article) |
9/62. pneumocephalus as a cause for headache.BACKGROUND: pneumocephalus can be a cause of headache, but is easily overlooked in some clinical circumstances. CASE STUDY: A 35-year-old woman developed severe headache of abrupt onset during an epidural blood patch procedure done for a post-lumbar puncture headache. A brain CT scan showed subarachnoid air even though there was no evidence of a dural puncture having occurred during the procedure. RESULTS: The experience of our patient, and a review of the literature suggests that air injected into the epidural space during use of the "loss of resistance" technique can enter the subarachnoid space if a dural puncture site from a previous lumbar puncture is present. CONCLUSIONS: pneumocephalus should be considered as a potential cause for a severe headache occurring in association with epidural procedures, and also in a number of other clinical settings. Use of a high inspired air oxygen concentration can hasten absorption of an intracranial air collection.- - - - - - - - - - ranking = 0.0064835864274514keywords = brain (Clic here for more details about this article) |
10/62. pneumocephalus. A sign of intracranial involvement in orbital fracture.Fractures of the orbit resulting from blunt or penetrating injury that involve the paranasal sinuses may tear the dura and allow air to enter the cranial cavity (pneumocephalus). pneumocephalus is sometimes the only sign of intracranial involvement. It is characteristically delayed in onset and clinically unsuspected, so that routine follow-up roentgenograms of patients with orbitosinus fractures may be the only means of assuring early detection. Roentgenographically, the air may be seen in spidural, subdural subarachnoid, intracerebral, or intraventricular locations. Prophylactic parenterally administered antibiotics may prevent intracranial infection. However, since about 25% of patients still develop meningitis, surgical repair of the dural fistula is often necessary.- - - - - - - - - - ranking = 0.8225784501831keywords = intracerebral, cerebral (Clic here for more details about this article) |
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