Department of Neurosurgery, Monash Health, Melbourne, Australia.
Department of Neurosurgery, St Vincent's Health, Melbourne, Australia.
World Neurosurg. 2020 Sep;141:357-362. doi: 10.1016/j.wneu.2020.06.079. Epub 2020 Jun 17.
Tension pneumocephalus (TP) is a rare but feared complication of endoscopic endonasal skull base surgery. In contrast to simple pneumocephalus, which is common after endoscopic transnasal approaches and managed conservatively, TP represents a neurosurgical emergency and mandates urgent decompression.
Here we present 2 cases of TP as a consequence of positive pressure ventilation following endoscopic endonasal skull base surgery. Both occurred during resuscitation for postoperative hypoxia. These cases prompted the development of an institution-wide protocol to identify and manage patients at risk of TP after extended skull base approaches.
To our knowledge, these are the only such cases of postoperative TP following positive pressure ventilation in the literature.
张力性气颅（TP）是内镜经鼻颅底手术罕见但可怕的并发症。与内镜经鼻入路后常见的单纯性气颅不同，TP 是一种神经外科急症，需要紧急减压。
在此，我们报告 2 例内镜经鼻颅底手术后因正压通气引起的 TP。这 2 例均发生在术后缺氧复苏期间。这些病例促使我们制定了一项全院范围的方案，以识别和管理在广泛的颅底入路后有发生 TP 风险的患者。
据我们所知，这是文献中唯一报道的术后正压通气引起的 TP 病例。
