Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University, Anyang, Korea.
Korean J Anesthesiol. 2010 Dec;59 Suppl(Suppl):S183-6. doi: 10.4097/kjae.2010.59.S.S183. Epub 2010 Dec 31.
Pneumocephalus is a condition which usually results from head trauma. It has been known that iatrogenic pneumocephalus can occur as a complication of positive pressure mask ventilation during induction of anesthesia or ventilatory care for head trauma patients. We report a case of mask ventilation during anesthesia induction in a 50-year-old male patient with head trauma. Initial pneumocephalus associated with cerebrospinal fluid leakage was diagnosed immediate following head injury involving facial sinuses. He was managed with emergent lumbar drainage and supportive care. Pneumocephalus recurred following positive pressure mask ventilation (PPMV) during anesthesia induction for surgery on the right arm. Recurred pneumocephalus was managed with high flow oxygen and supportive care. Anesthesiologists should be aware of pneumocephalus as a potential complication of PPMV in head trauma patients, even after resolution of previous pneumocephalus.
气颅是一种通常由头部外伤引起的病症。已知医源性气颅可作为麻醉诱导期间正压面罩通气或头部外伤患者通气护理的并发症发生。我们报告了一例头部外伤患者在麻醉诱导期间使用面罩通气的病例。头部外伤后立即诊断出与脑脊液漏相关的初始气颅。他通过紧急腰椎引流和支持性治疗进行管理。在为右臂手术进行麻醉诱导期间使用正压面罩通气 (PPMV) 后，气颅再次发生。再次发生的气颅通过高流量氧气和支持性治疗进行管理。即使在先前的气颅解决后，麻醉师也应该意识到气颅是头部外伤患者 PPMV 的潜在并发症。
