title: Pneumocephalus after resection of a lung cancer with posterior chest wall involvement.
abstract: Pneumocephalus after resection of intrathoracic tumors is an extremely rare event. A delayed presentation of iatrogenic subarachnoid pleural fistula resulted in symptomatic pneumocephalus after resection of a locally recurrent T4N0 nonsmall cell lung cancer involving the chest wall, T2 to T4 rib heads, and intercostal vertebral foramina. Progressive neurologic decline was noted 3 weeks after discharge. Computed tomography of the head and chest confirmed the presence of an apical pleural space, thoracic subarachnoid air, and pneumocephalus. Immediate clinical improvement followed chest tube decompression of the pleural space.
authors.affiliation: Division of Thoracic Surgery, Heart, Lung, and Esophageal Surgery Institute, University of Pittsburgh, Pittsburgh, Pennsylvania 15232, USA. schuchertmj@upmc.edu
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Schuchert
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Myers
authors.forename: John
authors.initials: J
authors.lastname: DeGraft-Johnson
authors.forename: Ghassan K
authors.initials: GK
authors.lastname: Bejjani
authors.forename: James D
authors.initials: JD
authors.lastname: Luketich
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Landreneau
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011007:Pneumocephalus / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000473:pathology*; D013524:Surgical Flaps; D035441:Thoracic Wall / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome