title: Delayed otogenic pneumocephalus complicating ventriculoperitoneal shunt.
abstract: Tension pneumocephalus complicating ventriculoperitoneal shunt is extremely rare. We report an elderly male who developed delayed tension pneumocephalus 12 months after ventriculoperitoneal shunt for hydrocephalus complicating aneurysmal subarachnoid hemorrhage. Fine-cut reformatted computer tomography scan revealed a large pneumatocele on the petrous apex associated with tegmen tympani defect. The shunt valve pressure was temporarily raised from 120 mm H 2 O to 200 mm H 2 O, and the patient underwent successful subtemporal extradural repair of the bony defect in the temporal bone. Although extremely rare, otogenic tension pneumocephalus is a potentially life-threatening condition, and urgent surgical repair of the bony defect in the temporal bone reduces the risk of both the morbidity and mortality.
authors: Department of Neurosurgery, University of Pisa, Pisa, Italy.
authors: Francesco
authors: F
authors: Pieri
authors: Carla Daniela
authors: CD
authors: Anania
authors: Paolo
authors: P
authors: Perrini
authors: Michele
authors: M
authors: Puglioli
authors: Giuliano Francesco
authors: GF
authors: Parenti
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011007:Pneumocephalus / Q000000981:diagnostic imaging / Q000209:etiology*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D013345:Subarachnoid Hemorrhage / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*