title: Pneumocephalus after Pancoast's tumor surgery: to be or not to be conservative?
abstract: We report a case of a 62-year-old man affected by Pancoast's tumor who developed pneumocephalus 17 days after right upper lobectomy with en bloc resection of the first three ribs and C8-D1 branches of the brachial plexus. The patient complained of aphasia, disorientation and sphincterial release. A chest and brain-CT scan showed a right apical pneumothorax associated with a massive pneumocephalus of the ventricles and of the subarachnoidal spaces. A pneumoperitoneum was also seen. The patient was treated using pleural drainages, Trendelenburg's position and antibiotic therapy. Clinical and radiological remission was achieved after 12 days of additional hospital stay.
authors.affiliation: Thoracic Surgery Division, European Institute of Oncology, Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Scanagatta
authors.forename: F
authors.initials: F
authors.lastname: Leo
authors.forename: G
authors.initials: G
authors.lastname: Veronesi
authors.forename: P
authors.initials: P
authors.lastname: Solli
authors.forename: R
authors.initials: R
authors.lastname: Gasparri
authors.forename: D
authors.initials: D
authors.lastname: Galetta
authors.forename: F
authors.initials: F
authors.lastname: Petrella
authors.forename: A
authors.initials: A
authors.lastname: Borri
authors.forename: L
authors.initials: L
authors.lastname: Spaggiari
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery*; D004322:Drainage / Q000379:methods; D018475:Head-Down Tilt; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010178:Pancoast Syndrome / Q000473:pathology / Q000601:surgery*; D011007:Pneumocephalus / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D011013:Pneumonectomy / Q000009:adverse effects* / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents