Kanner A A, Nageris B I, Chaimoff M, Rappaport Z H
Department of Neurosurgery, Rabin Medical Center, Petah Tiqva, Israel.
Neurosurgery. 2000 Apr;46(4):1002-4. doi: 10.1227/00006123-200004000-00048.
A unique case of spontaneous pneumocephalus is described. It appeared a few years after the uneventful introduction of a cerebrospinal fluid shunt and was probably attributable to a defect of the posterior mastoid plate.
A 65-year-old man presented with a subacute onset of vertigo, vomiting, and atactic gait instability. The patient had undergone a ventriculoperitoneal shunt implantation 2 years previously for communicating hydrocephalus. A computed tomographic scan revealed a posterior fossa pneumatocele without hydrocephalus.
A simple mastoidectomy was performed. Detection of the area of the bone defect was followed by mastoid obliteration with abdominal fat.
Clinicians should be aware that pneumocephalus can occur spontaneously, with or without obvious shunt problems. Treatment should be directed toward the area through which air penetrated the posterior fossa.
描述了一例罕见的自发性气颅病例。该病例在脑脊液分流术顺利实施数年之后出现，可能归因于后乳突板的缺损。
一名65岁男性出现眩晕、呕吐及共济失调步态不稳的亚急性发作。该患者两年前因交通性脑积水接受了脑室腹腔分流术植入。计算机断层扫描显示后颅窝有一个无脑积水的气囊肿。
实施了简单的乳突切除术。在检测到骨缺损区域后，用腹部脂肪对乳突进行了填塞。
临床医生应意识到，气颅可自发发生，无论有无明显的分流问题。治疗应针对空气进入后颅窝的区域。
