[Traumatic subarachnoid-pleural fistula causing tension pneumocephalus]

Uncommon subarachnoid-pleural fistula can be caused by a blunt or penetrating trauma and can also occur after a thoracal or neurosurgical operation, ending to a progredient pneumocephalus. Clinical findings might be an enlarging tension pneumocephalus without a cranial fracture, but in most times they will be overlayed by other accompanied injuries, neurologic symptoms can dominate, also rapidly filling clear pleural effusions with obscure cause. Oppurtune identification of the reason of the pneumocephalus and mostly early surgical intervention prevent neurological deficit, CNS infection and other complications.