Postoperative brain stem tension pneumocephalus causing transient locked-in syndrome.
The incidence of pneumocephalus after supratentorial craniotomy has been reported to be as high as 100%. However, transformation of postoperative pneumocephalus into tension pneumocephalus (symptomatic intracranial air) is a rather rare phenomenon. Tension pneumocephalus after posterior fossa surgery is reported mainly when the surgery is performed in a sitting position. We hereby report on a patient who developed brain-stem tension pneumocephalus in the early postoperative period after posterior fossa craniotomy for an exophytic brainstem astrocytoma, operated in the prone position. A complete locked-in syndrome resolved following surgical relief of the trapped air.
Biyani
N
N
Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv Medical Center, Tel-Aviv University, Tel Aviv, Israel.
Silbiger
A
A
Ben-Ari
J
J
Constantini
S
S
D000293:Adolescent; D001933:Brain Stem / Q000473:pathology*; D003399:Craniotomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D011007:Pneumocephalus / Q000175:diagnosis* / Q000209:etiology; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D011782:Quadriplegia / Q000175:diagnosis* / Q000209:etiology