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Acute Management of Tension Pneumocephalus in a Pediatric Patient: A Case Report

Lauren M L'Hommedieu1, Michael W Dingeldein2, Krystal L Tomei3

  • 1Division of Pediatric Emergency Medicine, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, Ohio.

The Journal of Emergency Medicine
|December 3, 2017
PubMed

Insights

Tension pneumocephalus, a dangerous buildup of air in the skull, can arise after head trauma. Prompt airway management and surgical intervention are crucial for emergency physicians managing such cases.

Area of Science:

  • Emergency Medicine
  • Neurosurgery
  • Trauma Care

Background:

  • Tension pneumocephalus is a rare, life-threatening condition characterized by intracranial air accumulation causing increased intracranial pressure and mass effect.
  • It most commonly develops secondary to head trauma, particularly involving the orbits or sinuses.

Observation:

  • A 13-year-old male with facial trauma from a motor vehicle collision presented with tension pneumocephalus identified via computed tomography.
  • The patient received immediate rapid sequence intubation without prior positive pressure ventilation in the emergency department.

Findings:

  • At craniotomy, the tension pneumocephalus had resolved spontaneously.
  • The patient achieved a complete recovery following the intervention.

Implications:

  • Emergency physicians must recognize the risk of tension pneumocephalus in patients with head or facial trauma and pneumocephalus.
  • Aggressive airway management, including rapid sequence intubation without positive pressure ventilation, and early surgical consultation are recommended for these critical cases.
Abstract

Keywords:
head traumapneumocephalustension pneumocephalus

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