Brain stem tension pneumocephalus leading to respiratory distress after subdural haematoma evacuation.

摘要

Pneumocephalus, or air within the intracranial cavity, is a common occurrence after the cranial surgery. Tension pneumocephalus in the posterior fossa compressing brain stem is previously reported in the sitting or prone position. To the best of our knowledge, it has not been reported in the supine position. We report a case of brain stem tension pneumocephalus after craniotomy for chronic subdural haematoma (SDH) evacuation performed in supine position. Increase in the intracranial pressure due to pneumocephalus leads to postoperative respiratory distress requiring mechanical ventilation. A 54-year-old, 70-kg man admitted with bilateral chronic SDH was scheduled for left craniotomy and haematoma evacuation, followed by burr hole evacuation of haematoma on the right side under general anaesthesia. All preoperative investigations including pulmonary function tests were within normal limits.