Tension pneumocephalus: a rare complication after hyperbaric oxygen therapy.
The study aimed to describe a patient with multiple skull bone fractures and a cerebrospinal fluid (CSF) leak who received hyperbaric oxygen therapy (HBOT). A 40-year-old man presented with subdural hemorrhage, skull bone fractures, facial bone fractures, sinus fractures, and CSF leakage after a one-story fall. He received HBOT as an adjunctive treatment to reduce brain edema and increase oxygen availability in brain tissue. Tension pneumocephalus developed after HBOT. Bur hole drainage was performed emergently to relieve the tension pneumocephalus. Cranioplasty and repair of skull base fracture were subsequently performed. The patient was discharged in a vegetative state. We proposed a possible mechanism by which tension pneumocephalus developed after HBOT sessions in this patient. Pneumocephalus, untreated skull base fracture, and CSF leakage should be considered contraindications to HBOT.
Lee
Ching-Hsing
CH
Department of Emergency Medicine, Chang Gung Memorial Hospital, Taipei, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
Chen
Wei-Chun
WC
Wu
Chao-I
CI
Hsia
Te-Chun
TC
D000058:Accidental Falls; D000328:Adult; D006259:Craniocerebral Trauma / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects*; D008297:Male; D018458:Persistent Vegetative State; D011007:Pneumocephalus / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed