Wang Arthur, Solli Elena, Carberry Nathan, Hillard Virany, Tandon Adesh
Department of Neurosurgery, New York Medical College, Westchester, Valhalla, NY, USA.
Case Rep Surg. 2016;2016:7534571. doi: 10.1155/2016/7534571. Epub 2016 Dec 15.
Tension pneumocephalus is a rare complication of head trauma and neurosurgical procedures, amongst other causes. It is defined by the combination of intracranial air, increased intracranial pressure, and mass effect. Although it often presents soon after surgery, it can also rarely present in a delayed fashion. We present a case of delayed tension pneumocephalus, occurring approximately 16 weeks after bifrontal craniectomy for a self-inflicted gunshot wound. Following a month of rhinorrhea, postnasal drip, and cough, the patient presented with a sensation of expansion in the area of the right forehead. As tension pneumocephalus is an emergency that can be fatal, this patient was treated expediently and avoided severe neurological deficits. The case recounted here is important as a demonstrative example that tension pneumocephalus does not always follow a defined course immediately after trauma or neurosurgery but rather can develop insidiously without obvious signs.
张力性气颅是头部创伤和神经外科手术等多种原因导致的一种罕见并发症。它由颅内积气、颅内压升高和占位效应共同定义。虽然它常在手术后不久出现，但也很少会延迟出现。我们报告一例延迟性张力性气颅病例，发生在因自残枪伤行双额开颅术后约16周。在经历了一个月的鼻漏、鼻后滴漏和咳嗽后，患者出现右前额区域膨胀感。由于张力性气颅是一种可能致命的急症，该患者得到了及时治疗，避免了严重的神经功能缺损。这里讲述的病例很重要，作为一个示范案例表明张力性气颅并非总是在创伤或神经外科手术后立即遵循特定病程，而是可能在没有明显迹象的情况下隐匿发展。
