Tension pneumocephalus after transsphenoidal surgery for acromegaly.
The Authors report the case of a 27-year-old man who developed intraventricular and subarachnoid tension pneumocephalus after removal of a large pituitary adenoma via the transnasal approach. This exceptional complication was probably caused by the combined action of a cerebrospinal fluid fistula plus an external lumbar subarachnoid drain, and resolved after removal of the spinal catheter. Such a conservative treatment was allowed in this case by the absence of a shift of midline structures due to bilateral intraventricular air collection. Usually, however, tension pneumocephalus is a life-threatening condition that requires prompt intervention. Meticulous attention to the cerebrospinal fluid draining system is needed in patients with a fistula to avoid the development of this unusual complication.
Candrina
R
R
Cattedra di Patologia Medica, Università degli Studi di Brescia, Italy.
Galli
G
G
Rossi
M
M
Bollati
A
A
D000172:Acromegaly / Q000150:complications*; D000236:Adenoma / Q000150:complications / Q000601:surgery*; D000328:Adult; D002557:Cerebrospinal Fluid Shunts; D006801:Humans; D007016:Hypophysectomy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D010911:Pituitary Neoplasms / Q000150:complications / Q000601:surgery*; D011007:Pneumocephalus / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D011859:Radiography