Sangeetha T S, Muraleedharan A
Department of ENT, Gleneagles Global Health City, Chennai, India.
Indian J Otolaryngol Head Neck Surg. 2023 Apr;75(Suppl 1):668-671. doi: 10.1007/s12070-022-03223-w. Epub 2022 Oct 25.
Tension Pneumocephalus and spontaneous CSF rhinorrhea are very rare associations in clinical practice. We report a case of 65 years old male with clear rhinorrhea, severe frontal headache, vomiting and lethargy for a week. MR Cisternography and CT Paranasal sinuses showed significant Tension Pneumocephalus with defect in the posterior wall of sphenoid sinus and CSF pooling in the sphenoid sinus. Endoscopic trans-sphenoidal CSF leak repair was done without any delay followed by complete resolution of Tension Pneumocephalus with in 4 post op days. Prompt precise diagnosis and early intervention of Tension Pneumocephalus is vital to avoid neurological complications.
张力性气颅与自发性脑脊液鼻漏在临床实践中是非常罕见的关联情况。我们报告一例65岁男性，有清亮鼻漏、严重额部头痛、呕吐及嗜睡一周。磁共振脑池造影和鼻窦CT显示有明显的张力性气颅，蝶窦后壁有缺损且蝶窦内有脑脊液积聚。立即进行了内镜经蝶窦脑脊液漏修补术，术后4天内张力性气颅完全消退。对张力性气颅进行迅速准确的诊断和早期干预对于避免神经并发症至关重要。
