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Postoperative brain stem tension pneumocephalus causing transient locked-in syndrome
N Biyani1, A Silbiger, J Ben-Ari
1Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv Medical Center, Tel-Aviv University, Tel Aviv, Israel.
Pediatric Neurosurgery
|September 6, 2007
Summary
Tension pneumocephalus, or symptomatic intracranial air, is rare after posterior fossa surgery. This case highlights a brain-stem tension pneumocephalus in the prone position, successfully treated surgically.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Postoperative pneumocephalus is common after craniotomy, but tension pneumocephalus (TP) is rare.
- TP after posterior fossa surgery is typically associated with the sitting position.
- This case explores TP in the prone position following posterior fossa surgery.
Observation:
- A patient developed brain-stem tension pneumocephalus postoperatively after posterior fossa craniotomy for an exophytic brainstem astrocytoma.
- The surgery was performed in the prone position.
- The patient presented with a complete locked-in syndrome.
Findings:
- Early postoperative brain-stem tension pneumocephalus occurred despite the prone surgical position.
- Surgical decompression and relief of trapped intracranial air resolved the locked-in syndrome.
- This suggests TP can occur in the prone position after posterior fossa surgery.
Implications:
- Highlights a rare complication of posterior fossa surgery in the prone position.
- Emphasizes the importance of recognizing and managing TP, regardless of surgical position.
- Suggests potential for TP in brainstem surgeries even without the sitting position.
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