De Jesus Orlando, Fernández-de Thomas Ricardo J, Feliciano Caleb
Department of Neurosurgery, University of Puerto Rico, San Juan, United States.
Surg Neurol Int. 2022 May 13;13:202. doi: 10.25259/SNI_64_2022. eCollection 2022.
Tension pneumoventricle is a rare, life-threatening complication. It has been rarely described in patients with ventriculoperitoneal (VP) shunts.
A 28-year-old male patient with a VP shunt became progressively lethargic after falling from his wheelchair. Skull X-rays and head CT scan showed abundant air inside the ventricles. He was taken to the operating room, and the shunt was revised without improvement. Two days later, a frontal external ventricular drain was placed to remove the air. In the investigation toward the etiology of the pneumoventricle, a review of previous head CT scans and brain MRIs showed that the patient had a small left frontonasal meningoencephalocele extending into the ethmoid, which had been unnoticed. He underwent repair of the defect with adequate sealing of the frontal skull base.
In a shunted patient with moderate or severe symptoms from a tension pneumoventricle, external ventricular drainage is required to remove the air as the shunt is inadequate.
张力性脑室积气是一种罕见的、危及生命的并发症。在脑室腹腔（VP）分流患者中鲜有描述。
一名28岁男性VP分流患者从轮椅上摔下后逐渐变得嗜睡。颅骨X线和头部CT扫描显示脑室内有大量气体。他被送往手术室，对分流装置进行了修复，但情况并未改善。两天后，放置了额部外部脑室引流管以排出气体。在对脑室积气病因的调查中，回顾之前的头部CT扫描和脑部MRI发现，患者有一个小的左侧额鼻脑膜脑膨出延伸至筛窦，此前未被注意到。他接受了缺损修复，并对额颅底进行了充分密封。
对于因张力性脑室积气出现中度或重度症状的分流患者，由于分流装置不足，需要进行外部脑室引流以排出气体。
