[Intractable intraoperative brain herniation secondary to tension pneumocephalus: a rare life-threatening complication during drainage of subdural empyema].
Tension pneumocephalus is rare but has been well documented following trauma and neurosurgical procedures. It is a surgical emergency as it can lead to neurological deterioration, brainstem herniation and death. Unlike previous cases where tension pneumocephalus developed postoperatively, we describe a case of intraoperative tension pneumocephalus leading to sudden, massive open brain herniation out of the craniotomy site. The possible causative factors are outlined. It is imperative to rapidly identify possible causes of acute intraoperative brain herniation, including tension pneumocephalus, and institute appropriate measures to minimize neurological damage.
University of Malaya, Faculty of Medicine, Department of Anesthesiology, Kuala Lumpur, Malásia. Electronic address: foolilian79@yahoo.com.
Li Lian
LL
Foo
University of Malaya, Faculty of Medicine, Department of Anesthesiology, Kuala Lumpur, Malásia.
Sook Hui
SH
Chaw
University of Malaya, Faculty of Medicine, Department of Anesthesiology, Kuala Lumpur, Malásia.
Lucy
L
Chan
University of Malaya, Faculty of Medicine, Department of Surgery, Kuala Lumpur, Malásia.
Dharmendra
D
Ganesan
University Malaya Medical Centre, Department of Surgery, Kuala Lumpur, Malásia.
Ravindran
R
Karuppiah
D000328:Adult; D001927:Brain Diseases / Q000209:etiology*; D004322:Drainage; D013354:Empyema, Subdural / Q000601:surgery*; D005260:Female; D006547:Hernia / Q000209:etiology*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D011007:Pneumocephalus / Q000150:complications*; D012720:Severity of Illness Index
Amputação cerebral; Brain amputation; Herniação cerebral no intraoperatório; Hydrogen peroxide; Intraoperative brain herniation; Peróxido de hidrogênio; Pneumoencéfalo hipertensivo; Tension pneumocephalus