[Massive pneumocephalus and cerebrospinal fluid fistula after thoracotomy].
We report the case of a 70-year-old man (ASA physical status 2) who developed massive pneumocephalus caused by a fistula between the subarachnoid and pleural spaces following a left pneumonectomy. After an uneventful immediate postoperative period, the patient was readmitted to the recovery care unit with dyspnea, intense headache, confusion, and diminished level of consciousness. Computed tomography confirmed a cerebrospinal fluid fistula secondary to the opening of the intradural space during tumor resection. Treatment was conservative, consisting of rest in a slightly Trendelenburg position, antibiotic prophylaxis to prevent meningitis, and a water seal on the thoracic drainage tube.
Olarra
J
J
Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario de Fuenlabrada, Madrid.
Longarela
A
A
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004388:Dura Mater / Q000293:injuries*; D005402:Fistula / Q000209:etiology*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D010995:Pleural Diseases / Q000209:etiology*; D011007:Pneumocephalus / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D011013:Pneumonectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D013122:Spinal Diseases / Q000209:etiology*; D013346:Subarachnoid Space; D013908:Thoracotomy / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed