Severe tension pneumocephalus complicating frontal sinus osteoma.
BACKGROUND
Tension pneumocephalus, the accumulation of intracranial gas under pressure, is a rare but potentially life-threatening condition which can complicate craniofacial surgery, trauma, or cranial tumor. It presents as an acute or subacute expanding mass lesion.


METHODS
We present a case of a 40-year-old male who developed tension pneumocephalus as a consequence of a previously detected but untreated frontal sinus osteoma. Despite prompt decompression and repair of the fistulous connection between the sinus and the intracranial compartment, the patient suffered permanent frontal lobe damage with significant neurocognitive sequelae and seizures.


CONCLUSIONS
This case illustrates that tension pneumocephalus can be a dangerous entity with potential for early mortality and long-term morbidity. We recommend, therefore, early treatment and close follow up of destructive lesions involving the posterior frontal sinus wall.
Marras
L C
LC
Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.
Kalaparambath
T P
TP
Black
S E
SE
Rowed
D W
DW
D000328:Adult; D003072:Cognition Disorders / Q000209:etiology; D005626:Frontal Sinus / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D010016:Osteoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D010255:Paranasal Sinus Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D011007:Pneumocephalus / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011183:Postoperative Complications; D012640:Seizures / Q000209:etiology; D014057:Tomography, X-Ray Computed