Rajan V T T, Dharini G Krrithvi, Anand V S Sathish, Nandish H S
Department of Neurosurgery, Saveetha University, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India.
Saveetha University, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India.
J Neurosci Rural Pract. 2020 Jan;11(1):187-190. doi: 10.1055/s-0039-3399615. Epub 2020 Mar 3.
Tension pneumocephalus (TPC) is a neurosurgical emergency that occurs when there is an expansion of trapped intracranial gas causing raised intracranial pressure. Rarely, posttraumatic TPC can occur even after 72 hours although the initial scans are normal. There are less than 20 cases of delayed TPC in the reported literature. Here, we report a case of delayed TPC that occurred 7 days after the initial injury and presented as sudden neurological deterioration. It was promptly diagnosed with a computed tomography brain and appropriate surgical intervention was performed and the outcome was good. We also did a literature review of reported cases of delayed TPC and looked out for factors that may predict its occurrence. The occurrence of an episode of cerebrospinal fluid rhinorrhea, followed by worsening of headache and sensorium in a patient with anterior cranial fossa fracture should alert a neurosurgeon to the possibility of delayed TPC.
张力性气颅（TPC）是一种神经外科急症，当颅内被困气体膨胀导致颅内压升高时发生。尽管初始扫描正常，但创伤后TPC甚至可在72小时后发生，这种情况很少见。在已报道的文献中，延迟性TPC病例少于20例。在此，我们报告一例延迟性TPC病例，该病例在初次受伤7天后发生，表现为突然的神经功能恶化。通过脑部计算机断层扫描迅速确诊，并进行了适当的手术干预，结果良好。我们还对已报道的延迟性TPC病例进行了文献综述，并寻找可能预测其发生的因素。前颅窝骨折患者出现脑脊液鼻漏，随后头痛和意识状态恶化，应提醒神经外科医生注意延迟性TPC的可能性。
