Department of Neurosurgery, University of Pisa, Pisa, Italy.
Neurol India. 2011 Jul-Aug;59(4):616-9. doi: 10.4103/0028-3886.84350.
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.
张力性气颅并发脑室-腹腔分流术极为罕见。我们报告一例老年男性患者，在因蛛网膜下腔出血并发的脑积水行脑室-腹腔分流术后 12 个月出现迟发性张力性气颅。薄层重建 CT 扫描显示，岩骨尖部有一个大的气囊肿，伴鼓室天盖缺损。暂时将分流阀压力从 120mmHg 升高至 200mmHg，患者成功接受了颞骨骨缺损的颞下硬膜外修复。尽管极为罕见，但耳原性张力性气颅是一种潜在的危及生命的疾病，及时手术修复颞骨骨缺损可降低发病率和死亡率。
