Savran Yusuf, Karacam Volkan, Bayram Basak, Yaka Erdem, Karabay Nuri
Department of Internal Medicine, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
Department of Thoracic Surgery, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
Turk J Emerg Med. 2016 Jul 4;17(1):1-3. doi: 10.1016/j.tjem.2016.06.002. eCollection 2017 Mar.
Pneumocephalus is a complication of trauma to the chest and many iatrogenic interventions. It may arise due to systemic air embolism or retrograde cerebral venous air embolism which is an extremely rare complication. We report a 26-years-old female patient who presented to the Emergency Department suffering of multiple stab wounds. She was in a state of shock and after first aid and evaluation she was operated successfully. In the early postoperative period generalized tonic clonic convulsions were observed following cardiopulmonary resuscitation due to sudden cardiovascular collapse. Brain computerized tomography demonstrated free air in intracranial and extracranial venous structures. Pneumocephalus was diagnosed which may be due to a wide spectrum of etiologies including thorax or spinal stab wounds, tube thoracostomy, cardiopulmonary resuscitation or even central venous catheterization. Unfortunately, the patient ended up with brain death despite all effort. In conclusion, we recommend physicians to be aware of this catastrophic complication while taking care of patients with stab wounds.
气颅是胸部创伤和许多医源性干预的并发症。它可能由于系统性空气栓塞或逆行性脑静脉空气栓塞引起，后者是一种极其罕见的并发症。我们报告一名26岁女性患者，因多处刺伤被送往急诊科。她处于休克状态，经过急救和评估后成功接受了手术。术后早期，因突然的心血管衰竭进行心肺复苏后，观察到全身性强直阵挛性惊厥。脑部计算机断层扫描显示颅内和颅外静脉结构中有游离气体。诊断为气颅，其病因可能多种多样，包括胸部或脊柱刺伤、胸腔闭式引流、心肺复苏甚至中心静脉置管。不幸的是，尽管全力抢救，患者最终还是脑死亡。总之，我们建议医生在治疗刺伤患者时要意识到这种灾难性并发症。
