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Pneumocephalus after thoracotomy

S A Malca1, P H Roche, A Touta

  • 1Department of Neurosurgery, Sainte Marguerite Hospital, Marseilles, France.

Surgical Neurology
|April 1, 1995
PubMed
Summary
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Pneumocephalus, or air in the skull, can rarely occur after thoracic surgery due to a fistula. Prompt diagnosis and treatment are crucial for managing this rare complication.

Area of Science:

  • Neurosurgery
  • Thoracic Surgery
  • Radiology

Background:

  • Pneumocephalus is a known condition, with rare causes including fistulas connecting the chest and the space around the brain.
  • This study focuses on pneumocephalus following thoracotomy.

Observation:

  • A new case of post-thoracotomy pneumocephalus is presented, alongside a review of eight similar cases from existing literature.
  • All reported cases involved surgery for intrathoracic tumors at the apex with chest wall invasion.
  • Diagnosis involved radiographic and isotopic examinations to identify pneumocephalus and the subarachnoid-pleural fistula.

Findings:

  • Neurological symptoms following thoracotomy can indicate pneumocephalus.
  • Complications included meningitis in one patient, and mortality in two patients.

Related Experiment Videos

  • The subarachnoid-pleural fistula was the underlying cause in these cases.

    • Implications:

    • Pneumocephalus should be considered in patients developing neurological issues post-thoracotomy.
    • Surgical closure of the fistula, either through thoracic or neurosurgical approaches, is recommended if conservative treatments are ineffective.
    • Early recognition and intervention are key to improving patient outcomes.