• Facial nerve palsy
• Lumbar discectomy
• Pneumocephalus

• csf leak
• endoscopic endonasal
• epidermoid cyst
• hydrocephalous
• tension pneumocephalus

• Air migration
• Brain tumor surgery
• Orbital emphysema
• Pneumocephalus

• Burr hole drainage
• Chronic subdural hematoma
• Cost reduction
• Postsurgical drainage
• Tension pneumocephalus

• Humans
• Hematoma, Subdural, Chronic/surgery
• Pneumocephalus/etiology
• Pneumocephalus/surgery
• Pneumocephalus/diagnostic imaging
• Drainage/methods
• Male
• Retrospective Studies
• Female
• Aged
• Middle Aged
• Aged, 80 and over
• Postoperative Complications/surgery
• Postoperative Complications/etiology
• Cohort Studies
• Craniotomy/methods
• Treatment Outcome
• Decompression, Surgical/methods
• Adult

• fat graft reconstruction
• irradiation
• pneumocephalus
• schwannoma
• tension pneumocephalus
• ventriculoperitoneal shunt

• Chronic Subdural Hematoma
• Diagnosis
• Drug treatment
• Pathogenic Mechanisms
• Review
• Surgical treatment

• Humans
• Hematoma, Subdural, Chronic/surgery
• Hematoma, Subdural, Chronic/therapy
• Hematoma, Subdural, Chronic/diagnosis
• Recurrence
• Neurosurgical Procedures/methods

• Tension pneumocephalus
• acute subdural hematoma
• case report
• craniotomy
• decompressive craniectomy

• cholesteatoma
• complications
• petrous bone
• pneumocephalus

• Female
• Humans
• Adult
• Petrous Bone/diagnostic imaging
• Pneumocephalus/diagnostic imaging
• Pneumocephalus/etiology
• Cholesteatoma/complications
• Cholesteatoma/diagnosis
• Headache
• Vestibule, Labyrinth

• Deep brain stimulation
• Movement disorders
• Pneumocephalus
• Surgical technique

• Humans
• Deep Brain Stimulation/adverse effects
• Deep Brain Stimulation/methods
• Retrospective Studies
• Pneumocephalus/diagnostic imaging
• Pneumocephalus/etiology
• Pneumocephalus/prevention & control
• Brain Neoplasms/etiology
• Wakefulness
• Parkinson Disease/surgery
• Parkinson Disease/etiology

• Anesthesia
• Empyema
• Pneumocephalus
• Septic meningitis
• Spinal-epidural anesthesia

• Pneumocephalus
• cranial nerve palsy
• lumbar puncture
• spinal procedures

• Humans
• Pneumocephalus/diagnostic imaging
• Pneumocephalus/etiology
• Cranial Nerve Diseases/etiology
• Cranial Nerve Diseases/complications
• Abducens Nerve Diseases/etiology
• Abducens Nerve Diseases/complications
• Spinal Puncture/adverse effects
• Cranial Nerves

• Medical management
• Meningitis
• Neurosurgery

• Male
• Humans
• Pneumocephalus/diagnostic imaging
• Pneumocephalus/etiology
• Meningitis, Bacterial/complications
• Meningitis, Bacterial/drug therapy
• Skull Base/surgery
• Anti-Bacterial Agents/therapeutic use
• Headache/drug therapy

• Neurosurgery
• Oxygen
• Pneumocephalus
• Surgery
• Trauma

• Humans
• Pneumocephalus/therapy
• Headache
• Oxygen

• blunt chest trauma
• brachial plexus avulsion
• cerebrospinal fluid leakage
• pneumocephalus
• pneumothorax

• early mobilization
• pneumocephalus
• rehablitation
• subarachnoid hemorrhage
• subdural hematoma

• abdominal pressurization
• laparoscopic-induced pneumocephalus
• ventriculoperitoneal shunt

• Female
• Humans
• Middle Aged
• Cholecystectomy, Laparoscopic/adverse effects
• Head/surgery
• Hydrocephalus/surgery
• Laparoscopy/methods
• Pneumocephalus/diagnostic imaging
• Pneumocephalus/etiology
• Ventriculoperitoneal Shunt

• Humans
• Pneumocephalus/diagnostic imaging
• Pneumocephalus/etiology
• Postoperative Complications
• Tomography, X-Ray Computed

• high-flow oxygen
• hyperoxygenation
• intracranial hypertension
• posterior fossa craniectomy
• tension pneumocephalus

• Humans
• Pneumocephalus/diagnostic imaging
• Pneumocephalus/etiology
• Posture
• Tomography, X-Ray Computed
• Postoperative Complications/diagnosis
• Postoperative Complications/therapy

• Analgesia
• Epidural
• Headache
• Pneumocephalus
• Post-dural puncture headache

• No. 2021ZYTS-12 Research and Development Funds of Xi'an Jiaotong University First Affiliated Hospital .

• babinski
• dural puncture
• epidural analgesia
• labour
• pneumocephalus

• Burr hole craniostomy
• Chronic subdural hematoma
• Clinical outcomes
• Meta-analysis
• Pneumocephalus
• Recurrence

• Humans
• Hematoma, Subdural, Chronic/surgery
• Prospective Studies

• 81502150 National Natural Science Foundation of China

• Adult spinal deformity
• MRSA
• NPWTi-d
• Pneumocephalus
• SSI
• Spine surgery

Postoperative pneumocephalus is associated with a higher risk of recurrence of chronic subdural hematoma (cSDH). However, there is no verified simple way to measure the pneumocephalus volume at the bedside for daily clinical use. The ABC/2 method was shown to be a simple and reliable technique to estimate volumes of intracranial lesions, such as intracranial hematomas. This study aims to evaluate the accuracy of the ABC/2 formula in estimating volumes of pneumocephalus, as compared to the gold standard with computer-assisted volumetric analysis.

A total of 141 postoperative computed tomographic (CT) brain scans of cSDH patients with burr-hole drainage were analysed. Pneumocephalus volume was measured independently by both the ABC/2 formula and the computer-assisted volumetric measurement. For the computer-assisted measurement, the volume of the air was semiautomatically segmented and calculated by computer software. Linear regression was used to determine the correlation between the ABC/2 method and computer-assisted measurement.

The postoperative pneumocephalus volume after bilateral burr-hole drainage was significantly larger than that of unilateral burr-hole drainage (29.34 ml versus 12.21 ml, p < 0.001). The estimated volumes by the formula ABC/2 significantly correlated to the volumes as measured by the computer-assisted volumetric technique, with r = 0.992 (p < 0.001). The Pearson correlation coefficient is very close to 1, which signifies a very strong positive correlation, and it is statistically significant.

An excellent correlation is observed between the ABC/2 method and the computer-assisted measurement. This study verified that the ABC/2 method is an accurate and simple “bedside” technique to estimate pneumocephalus volume.

• The ABC/2 method is an accurate and simple “bedside” technique to estimate pneumocephalus volume.

• The postoperative pneumocephalus volume after bilateral burr-hole drainage was significantly larger than that of unilateral burr-hole drainage (29.34 ml versus 12.21 ml, p < 0.001).

• The estimated volumes of pneumocephalus by the formula ABC/2 were significantly correlated to the volumes as measured by the computer-assisted volumetric technique, with r = 0.992 (p < 0.001).

• LP shunt
• congenital bone defect
• iNPH
• tension pneumocephalus

Pneumocephalus may be responsible for post-craniotomy headache but is easily overlooked in the clinical situation. In the present study, the relationship between the amount of intracranial air and post-craniotomy headache was investigated.

A retrospective observational study was performed on 79 patients who underwent minimal invasive craniotomy for unruptured cerebral aneurysms. Those who had undergone previous neurosurgery, neurological deficit before and after surgery were excluded The amount of air in the cranial cavity was measured using brain computed tomography (CT) taken within 6 h after surgery. To measure the degree of pain due to intracranial air, daily and total analgesic administration amount were used as a pain index. Correlation between intracranial air volume and total consumption of analgesic during hospitalization was tested using Spearman rank correlation coefficients. Receiver operating characteristics (ROC) analysis was used to determine the amount of air associated with increased analgesic consumption over 72 h postoperatively.

The mean amount of intracranial air was 15.6 ± 9.1 mL. Total administration of parenteral and oral analgesics frequency were 6.5 ± 4.5, 13.2 ± 7.9 respectively. A statically significant correlation was observed between daily and total parenteral analgesic consumption after surgery and the amount of intracranial air at followed-up brain CT postoperatively within 24 h (r = 0.69, p < 0.001), within 48 h (r = 0.68, p < 0.001), and total duration after surgery (r = 0.84, p < 0.001). The optimal cut-off value of 12.14 mL of intracranial air predicts the use of parenteral analgesics over 72 h after surgery.

Pneumocephalus may be a causative factor for post-craniotomy pain and headache with surgical injuries.

• Craniotomy
• Headache
• Pneumocephalus

Tension pneumocephalus is a neurosurgical emergency requiring prompt intervention. A variety of either temporizing or definitive methods was previously described as part of its management. Here, we report on an off-label use of a bed-side device and the subdural evacuating port system (SEPS)™ for the treatment of tension pneumocephalus.

The SEPS™ (Medtronic Dublin, Ireland) is a minimally invasive tool that is indicated for the removal of chronic or subacute subdural hematomas and at the patient’s bedside. We describe the use of this system to evacuate tension pneumocephalus.

A 44-year-old patient operated in our institution was presented with sudden obtundation 4 days post resection of esthesioneuroblastoma. Imaging confirmed a significant tension pneumocephalus. Immediate bedside decompression using a SEPS bolt placed frontally was performed, achieving rapid evacuation and patient regained consciousness. A definitive skull base reconstruction was done at the operating room at a later stage.

The SEPS™, well-known for evacuation of CSDH, can be potentially used as a bed-side tool to effectively treat mass effect created by tension pneumocephalus. As a readily-available and commercially used device, it can provide a simple and standard toolkit suitable for an emergent temporizing procedure.

A subcutaneous emphysema is an infrequent but potentially life‐threatening complication after dental treatment involving instruments functioning with pressurized air. Emphysemata after the use of high‐speed handpieces and air‐syringes are well documented, however, more recently several reports on emphysemata produced by air‐polishing devices during management of peri‐implant biological complications have appeared. To the best of our knowledge, direct development of pneumocephalus after a dental procedure has never been reported before. Introduction of air likely contaminated with oral bacteria to the intracranial space bares the risk of developing meningitis.

This case report describes the spreading of a subcutaneous emphysema into the intracranial space (i.e., development of a pneumocephalus) after treatment of a peri‐implantitis lesion with an air‐polishing device equipped with the nozzle for submucosal debridement. A subcutaneous emphysema was noticed during the use of an air‐polishing device and the subsequent computed tomography (CT) examination revealed a quite unexpected spreading of the emphysema into the intracranial space. The patient was admitted to the hospital for close surveillance, CT follow‐up, and intravenous antibiotics to prevent the development of meningitis due to the introduction of air—likely contaminated with oral bacteria—into the intracranial space. After 3 days, the patient was discharged in good condition without any further complications.

In case of an extensive subcutaneous emphysema as result of a dental procedure, a more extended radiographic examination including the mediastinal and cranial space should be considered, to assess the risk for potentially life‐threatening complications.

• air-polishing
• emphysema
• peri-implantitis
• pneumocephalus

Pneumocephalus is a rare complication presenting in the postoperative period of a thoracoscopic operation. We report a case in which tension pneumocephalus occurred after thoracoscopic resection as well as the subsequent approach of surgical management.

A 66-year-old man who received thoracoscopic resection to remove an intrathoracic, posterior mediastinal, dumbbell-shaped, pathology-proven neurogenic tumor. The patient then reported experiencing progressively severe headaches, especially when in an upright position. A brain computed tomography scan at a local hospital disclosed extensive pneumocephalus. Revision surgery for resection of the pseudomeningocele and repair of the cerebrospinal fluid leakage was thus arranged for the patient. During the operation, we traced the cerebrospinal fluid leakage and found that it might have derived from incomplete endoscopic clipping around the tumor stump near the dural sac at the T3 level. After that, we wrapped and sealed all the possible origins of the leakage with autologous fat, tissue glue, gelfoam, and duraseal layer by layer. The patient recovered well, and the computed tomography images showed resolution of the pneumocephalus.

This report and literature review indicated that the risk of developing a tension pneumocephalus cannot be ignored and should be monitored carefully after thoracoscopic tumor resection.

• Tension pneumocephalus
• Neurogenic tumor
• Thoracoscope
• Case report

• possible complications
• sitting position in neurosurgery
• therapy and prevention

• Embolism, Air/etiology
• Humans
• Neurosurgery
• Neurosurgical Procedures/adverse effects
• Posture/physiology
• Sitting Position

• Mount Fuji
• pneumochephalus
• subdural haematoma

• cranial nerve deficits
• ethmoidal malformation
• nasal cavity
• ventriculoscopy

• Pleural effusion
• Pneumocephalus
• Pneumorrhachis
• Pneumothorax
• Syringopleural shunting

We report a case of pneumocephalus, which is identified as the presence of air in the cranial cavity and is a rare complication after spinal surgeries, in addition to a literature review of similarly reported cases.

The patient is a 63-year-old male who developed pneumocephalus after undergoing a minimally invasive left side decompression at L3-L4 with left L4 foraminotomy even though there were no signs of dural tears or Cerebrospinal Fluid (CSF) leaks. After the diagnosis of pneumocephalus using brain Magnetic Resonance Imaging (MRI), the patient was treated conservatively and was discharged after 3 weeks without developing further complications.

Pneumocephalus is defined as an abnormal accumulation of air within the cranial cavity. It can occur due to a variety of causes but rarely due to gas forming bacteria. Many theories are suggested concerning the pathophysiology of pneumocephalus, the inverted bottle theory, the ball valve theory, the Nitrous Oxide (N₂O) theory, and as we outweigh in our case, gas forming bacteria theory. Pneumocephalus can be treated surgically, nevertheless, conservative management methods of such cases are usually followed.

The aim of this study is to draw further attention to the management and diagnosis of such surgical complication. A more extended research is needed to provide a full comprehensive approach to deal with this problem if faced in the future. To the best of our knowledge, this study reports the first pneumocephalus case induced by a postoperative bacterial infection in the global English based medical literature.

•

Pneumocephalus caused by gas forming infection in the spine is a rare complication after spinal surgery.

• Citrobacter freundii
• Gas forming bacteria
• Pneumocephalus
• Post-operative infection
• Spinal surgery

• Apergillosis
• Pneumocephalus
• Pneumorrhachis
• Transfrontal craniotomy

Tension pneumocephalus is the presence of air within the cranial vault compressing the ventricles and the brain parenchyma. High altitudes can exacerbate this problem, especially when a dural defect exists and air is forced into the cranial cavity with no way to escape. This case demonstrates a rare presentation of thoracic trauma causing tension pneumocephalus due to emergent air evacuation.

• mount fuji sign
• neurosurgery
• pneumocephalus
• tension pneumocephalus
• thoracic trauma

• emergency medicine
• infection (neurology)
• meningitis
• otolaryngology / ENT
• trauma

• case report
• delayed pneumocephalus
• percutaneous aspiration
• severe headache
• spine surgery

• Bone Neoplasms/pathology
• Bone Neoplasms/secondary
• Bone Neoplasms/surgery
• Carcinoma, Hepatocellular/pathology
• Carcinoma, Hepatocellular/surgery
• Decompression, Surgical/adverse effects
• Decompression, Surgical/methods
• Diuretics, Osmotic/administration & dosage
• Drainage/adverse effects
• Drainage/methods
• Humans
• Liver Neoplasms/pathology
• Liver Neoplasms/surgery
• Male
• Mannitol/administration & dosage
• Middle Aged
• Neoplasm Staging
• Neuroimaging/methods
• Orthopedic Procedures/adverse effects
• Orthopedic Procedures/methods
• Pneumocephalus/diagnosis
• Pneumocephalus/etiology
• Pneumocephalus/physiopathology
• Pneumocephalus/therapy
• Postoperative Complications/diagnosis
• Postoperative Complications/physiopathology
• Postoperative Complications/therapy
• Reoperation/adverse effects
• Reoperation/methods
• Thoracic Vertebrae/pathology
• Thoracic Vertebrae/surgery
• Treatment Outcome

• Animals
• Craniotomy/veterinary
• Dog Diseases/diagnostic imaging
• Dog Diseases/surgery
• Dogs
• Female
• Frontal Lobe/diagnostic imaging
• Frontal Lobe/surgery
• Male
• Neoplasms/veterinary
• Olfactory Bulb/surgery

• Abdominal aortic aneurysm
• Cerebrospinal fluid pressure
• Pneumocephalus
• Postdural puncture headache
• Postoperative complication
• Thoracic aortic aneurysm