Hernández-Palazón J, Sánchez-Bautista S, Tortosa Serrano J A, Mulero Cervantes J F, Martínez-Lage J F
Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen de la Arrixaca, Murcia.
Rev Esp Anestesiol Reanim. 1998 Feb;45(2):68-71.
Pneumocephalus occurs commonly soon after intracranial surgery. When it presents as a significant increase in intracranial pressure it is called pressure pneumocephalus, a severe, life-threatening complication of neurosurgery that requires immediate treatment. Tension pneumocephalus must be suspected in patients unexpectedly fail to awaken at the end of surgery or who present progressive neurological deterioration after posterior fossa surgery. Diagnosis is by computerized axial thomography of the brain. Treatment is simple, consisting of promptly releasing the pressurized gas by trephination to save the patient's life or prevent severe neurological sequelae. We report two cases of pressure pneumocephalus that illustrate several risk factors: sitting position during surgery, preoperative hydrocephaly, surgical opening of the fourth ventricular and the presence of cerebrospinal shunt during surgery.
