Tension pneumocephalus from an occult frontal sinus fracture following pituitary macroadenoma resection
Background: Tension pneumocephalus (TP), or the presence of intracranial air with additional neurologic decline, is a common complication after sinonasal surgery due to inadvertent iatrogenic damage to the dura and/or surrounding bony structures. Case description: We present the case of a 69-year-ol...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-12-01
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| Series: | Interdisciplinary Neurosurgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751920304412 |
| _version_ | 1818116879449849856 |
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| author | Alison M. Westrup Amy B. Parker Kibwei A. McKinney Chad A. Glenn |
| author_facet | Alison M. Westrup Amy B. Parker Kibwei A. McKinney Chad A. Glenn |
| author_sort | Alison M. Westrup |
| collection | DOAJ |
| description | Background: Tension pneumocephalus (TP), or the presence of intracranial air with additional neurologic decline, is a common complication after sinonasal surgery due to inadvertent iatrogenic damage to the dura and/or surrounding bony structures. Case description: We present the case of a 69-year-old man who underwent routine trans-sphenoidal resection of a pituitary macroadenoma with an uncomplicated hospital and discharge course. The patient subsequently developed sepsis and meningitis, and a spontaneous unilateral TP developed amidst the treatment course. Intraoperatively, no active leaks or post-operative injuries were discovered. However, on post-operative imaging, an occult, bony defect was found located in the right posterior table of the frontal sinus. The patient progressively improved to stable CT Brain over 14 days with the use of short term 100% inspired oxygen and bedside subdural port placement. Conclusions: This report highlights the impact of remote trauma in development of delayed tension pneumocephalus following endoscopic endonasal surgery. The clinical history, presentation, and management are reviewed. |
| first_indexed | 2024-12-11T04:29:32Z |
| format | Article |
| id | doaj.art-bd6c2890250d4dd3853d9fb073a2b6fa |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-12-11T04:29:32Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-bd6c2890250d4dd3853d9fb073a2b6fa2022-12-22T01:20:54ZengElsevierInterdisciplinary Neurosurgery2214-75192020-12-0122100880Tension pneumocephalus from an occult frontal sinus fracture following pituitary macroadenoma resectionAlison M. Westrup0Amy B. Parker1Kibwei A. McKinney2Chad A. Glenn3Department of Neurological Surgery, University of Oklahoma Medicine, Oklahoma City, OK, USA; Corresponding author.College of Medicine, University of Oklahoma, Oklahoma City, OK, USADepartment of Otorhinolaryngology/Head & Neck Surgery, University of Oklahoma Medicine, Oklahoma City, OK, USADepartment of Neurological Surgery, University of Oklahoma Medicine, Oklahoma City, OK, USABackground: Tension pneumocephalus (TP), or the presence of intracranial air with additional neurologic decline, is a common complication after sinonasal surgery due to inadvertent iatrogenic damage to the dura and/or surrounding bony structures. Case description: We present the case of a 69-year-old man who underwent routine trans-sphenoidal resection of a pituitary macroadenoma with an uncomplicated hospital and discharge course. The patient subsequently developed sepsis and meningitis, and a spontaneous unilateral TP developed amidst the treatment course. Intraoperatively, no active leaks or post-operative injuries were discovered. However, on post-operative imaging, an occult, bony defect was found located in the right posterior table of the frontal sinus. The patient progressively improved to stable CT Brain over 14 days with the use of short term 100% inspired oxygen and bedside subdural port placement. Conclusions: This report highlights the impact of remote trauma in development of delayed tension pneumocephalus following endoscopic endonasal surgery. The clinical history, presentation, and management are reviewed.http://www.sciencedirect.com/science/article/pii/S2214751920304412Tension pneumocephalusOccultNeurological surgeryTrans-sphenoidalMacroadenoma resectionCase report |
| spellingShingle | Alison M. Westrup Amy B. Parker Kibwei A. McKinney Chad A. Glenn Tension pneumocephalus from an occult frontal sinus fracture following pituitary macroadenoma resection Interdisciplinary Neurosurgery Tension pneumocephalus Occult Neurological surgery Trans-sphenoidal Macroadenoma resection Case report |
| title | Tension pneumocephalus from an occult frontal sinus fracture following pituitary macroadenoma resection |
| title_full | Tension pneumocephalus from an occult frontal sinus fracture following pituitary macroadenoma resection |
| title_fullStr | Tension pneumocephalus from an occult frontal sinus fracture following pituitary macroadenoma resection |
| title_full_unstemmed | Tension pneumocephalus from an occult frontal sinus fracture following pituitary macroadenoma resection |
| title_short | Tension pneumocephalus from an occult frontal sinus fracture following pituitary macroadenoma resection |
| title_sort | tension pneumocephalus from an occult frontal sinus fracture following pituitary macroadenoma resection |
| topic | Tension pneumocephalus Occult Neurological surgery Trans-sphenoidal Macroadenoma resection Case report |
| url | http://www.sciencedirect.com/science/article/pii/S2214751920304412 |
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