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Tension pneumocephalus after transsphenoidal surgery: two case reports

N Yüceer1, K Cakíroğlu, A Erdoğan

  • 1Department of Neurosurgery, Ankara University, School of Medicine, Ibn-i Sina Medical Centre, Turkey.

Acta Neurochirurgica
|January 1, 1995
PubMed
Summary

Epidural air formation, a complication of transsphenoidal surgery, can lead to tension pneumocephalus. This paper discusses contributing factors and conservative management in two patient cases.

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Area of Science:

  • Neurosurgery
  • Otolaryngology
  • Medical Imaging

Background:

  • Transsphenoidal surgery is a common approach for pituitary and skull base lesions.
  • Intracranial air accumulation can occur postoperatively, potentially leading to complications.
  • Tension pneumocephalus is a rare but serious complication characterized by increased intracranial pressure due to trapped air.

Observation:

  • Two cases of epidural air formation and subsequent tension pneumocephalus following transsphenoidal operations were identified.
  • Patients presented with symptoms indicative of increased intracranial pressure.
  • Radiological imaging confirmed the presence of significant epidural air collection.

Findings:

  • Factors contributing to intracranial air formation in these cases included surgical technique and anatomical variations.

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  • Conservative management, including observation and supportive care, was successful in both instances.
  • Resolution of symptoms and radiological air reduction were achieved without surgical intervention.

    • Implications:

    • Highlights the importance of recognizing and managing potential air embolism during and after transsphenoidal procedures.
    • Suggests that conservative treatment may be a viable option for select cases of post-transsphenoidal tension pneumocephalus.
    • Emphasizes the need for vigilant postoperative monitoring in patients undergoing transsphenoidal surgery.