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Pneumocephalus: an unusual cause.

R D'Addario, J Greenberg, T J O'Neill

Journal of Neurology, Neurosurgery, and Psychiatry

|March 1, 1974

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A patient developed intracranial air (pneumocephalus) after lung cancer surgery. This rare complication was likely caused by a persistent air leak from the chest into the brain through a surgical dural tear.

Area of Science:

Neurosurgery
Thoracic Surgery
Pulmonary Medicine

Background:

Bronchogenic carcinoma necessitates surgical intervention, often involving thoracotomy.
Post-operative complications can arise, impacting patient recovery and neurological status.
Pneumocephalus, the presence of air within the cranial cavity, is a recognized but uncommon complication.

Purpose of the Study:

To report a unique case of pneumocephalus following open thoracotomy for bronchogenic carcinoma.
To investigate the likely etiology of pneumocephalus in this specific clinical scenario.
To contribute to the literature by documenting an unusual post-surgical complication.

Main Methods:

Case report of a 60-year-old male patient undergoing open thoracotomy.

Related Experiment Videos

Clinical observation of post-operative obtundation and headache.

Radiographic confirmation of intracranial air (pneumocephalus).

Review of existing literature on causes of pneumocephalus.

Main Results:

The patient developed obtundation and headache on the twelfth hospital day.
Radiographs confirmed the presence of intracranial air.
The pneumocephalus was hypothesized to result from a tension pneumothorax forcing air through a dural tear sustained during surgery.
No similar case reports were identified in the literature.

Conclusions:

Pneumocephalus can be a rare and delayed complication after thoracic surgery.
A continuous air leak from a pneumothorax through a dural defect is a plausible mechanism.
This case highlights the importance of considering unusual complications in post-operative patients.