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Tension pneumocephalus: a rare complication after hyperbaric oxygen therapy
Ching-Hsing Lee1, Wei-Chun Chen, Chao-I Wu
1Department of Emergency Medicine, Chang Gung Memorial Hospital, Taipei, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
The American Journal of Emergency Medicine
|April 18, 2009
Summary
Hyperbaric oxygen therapy (HBOT) may cause tension pneumocephalus in patients with skull fractures and CSF leaks. Untreated skull base fractures and CSF leakage are potential contraindications for HBOT.
Area of Science:
- Neurosurgery
- Hyperbaric Medicine
- Trauma Care
Background:
- A patient with multiple skull fractures and cerebrospinal fluid (CSF) leak following trauma was treated with hyperbaric oxygen therapy (HBOT).
- HBOT was administered to reduce cerebral edema and enhance oxygen delivery to brain tissue.
Observation:
- The patient developed tension pneumocephalus, a serious complication, after receiving HBOT.
- Emergency burr hole drainage was required to manage the tension pneumocephalus.
Findings:
- The study describes a case where HBOT potentially contributed to the development of tension pneumocephalus in a patient with pre-existing skull fractures and CSF leakage.
- A possible mechanism for this complication is proposed, highlighting the risks associated with HBOT in such cases.
Implications:
- Pneumocephalus, untreated skull base fractures, and CSF leakage should be carefully considered as potential contraindications for HBOT.
- This case underscores the importance of thorough patient evaluation before HBOT, especially in trauma patients with complex cranial injuries.
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