title: Symptomatic tension pneumocephalus: an unusual post-operative complication of posterior spinal surgery.
abstract: Pneumocephalus is a rare, but serious complication of spinal surgery and its management and physiology is not widely recognized. Symptomatic tension pneumocephalus secondary to iatrogenic cerebrospinal fluid (CSF) leak after surgical intervention, and drainage with a vacuum suction device, has not been previously reported. We report a patient who underwent intervertebral disc surgery who developed pneumoencephalus after drainage with a vacuum suction device. Imaging showed significant pneumocephalus in the subarachnoid space of the frontal region and in the cisterns. The condition was resolved by discontinuation of the suction drainage, bed rest and hyperhydration. Thus, spinal drainage may predispose to entry of air intracranially and pneumocephalus. It is important to be aware of this serious post-operative complication in patients with a CSF fistula.
authors.affiliation: Department of Neurosurgery, Adnan Menderes University School of Medicine, TR-09100 Aydin, Turkey. drmturgut@yahoo.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Turgut
authors.forename: Orhan
authors.initials: O
authors.lastname: Akyüz
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011007:Pneumocephalus / Q000473:pathology* / Q000601:surgery; D011013:Pneumonectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000473:pathology / Q000503:physiopathology*; D013116:Spinal Cord / Q000601:surgery*; D013346:Subarachnoid Space / Q000473:pathology*