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Updated: Mar 16, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Spontaneous pneumocephalus from nasal continuous positive airway pressure in a patient with ventriculo-peritoneal
Brian Nee Hou Chee1, Muhammad Fahmi Abdul Jalil1, Kristian John Bulluss1
1Department of Neurosurgery, The Austin Hospital, 145 Studley Rd., Heidelberg 3084, VIC, Australia.
Abstract:
Pneumocephalus in patients receiving positive airway pressure ventilation commonly occurs in the setting of trauma or surgery. We report a case of atraumatic pneumocephalus in a patient with a ventriculoperitoneal (VP) shunt on nasal continuous positive airway pressure (CPAP) for obstructive sleep apnoea. The patient presented with a 1-week history of "gurgling" sensation in his head and ataxia, with CT scan findings of a significant pneumocephalus. As extensive work up did not reveal any cause for his pneumocephalus, the nasal CPAP was thought to be the source. The CPAP was discontinued with improvement of the pneumocephalus, and resolution of his symptoms. He subsequently represented with recurrence of his symptoms, and increasing pneumocephalus on imaging. This was successfully managed by increasing his shunt pressure.
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