Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have redu...Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have reduced the frequency and severity of common complications, reports of rare and serious complications such as pneumocephalus, remain scarce. Case Report: This article presents a case of pneumocephalus following CSEA in a middle-aged female patient undergoing surgery for an intrauterine space-occupying lesion. The patient experienced severe headache postoperatively, and imaging confirmed the presence of intracranial air. After receiving active symptomatic treatment, the patient recovered and was discharged. Conclusion: This case underscores the importance of adhering to standard anesthesia protocols and increasing awareness of rare CSEA complications, particularly the risk of pneumocephalus. Early recognition and timely management are crucial. There is a need to further enhance training and research in anesthetic procedures to improve clinical anesthesia quality and ensure patient safety.展开更多
Objective:To report a rare case of otogenic tension pneumocephalus as a complication of a diffuse leptomeningeal glioneuronal tumor in a patient with a ventriculoperitoneal(V.P.)shunt.Patients:Twenty-three-year-old ma...Objective:To report a rare case of otogenic tension pneumocephalus as a complication of a diffuse leptomeningeal glioneuronal tumor in a patient with a ventriculoperitoneal(V.P.)shunt.Patients:Twenty-three-year-old man with a confirmed diffuse leptomeningeal glioneuronal tumor diagnosis was treated for temporal bone defect and considerable pneumocephalus one year after V.P.shunt.Intervention(s):The patient underwent a Transmastoid,retrolabyrinthine approach.The defect was closed with temporalis facia graft and conchal cartilage as a double-layer closure,and then DuraSeal®was placed over the repaired area.Main outcome measure(s):Resolution of the pneumocephalus.Results:There was a significant reduction in the pneumocephalus on the first day post-operatively.Conclusions:Spontaneous or secondary pneumocephalus development should be considered in patients with brain tumors,hydrocephalus,and patients who undergo V.P.shunt insertion.展开更多
Pneumocephalus is an uncommon, often forgotten complication of meningitis caused by gas-producing organisms, especially in advanced aged patients. Attention should be paid to physical signs, and early computed tomogra...Pneumocephalus is an uncommon, often forgotten complication of meningitis caused by gas-producing organisms, especially in advanced aged patients. Attention should be paid to physical signs, and early computed tomography （CT） scan could be helpful in the diagnosis. Accurate antibiotics according to blood culture would be the key point in the treatment procedure.展开更多
Objectives: We critically reviewed our experiences in endocranial complications with Functional Endoscopic Sinus Surgery, and investigated the causes, prevention strategies and management. Methods: We conducted a retr...Objectives: We critically reviewed our experiences in endocranial complications with Functional Endoscopic Sinus Surgery, and investigated the causes, prevention strategies and management. Methods: We conducted a retrospective study of endocranial complications with Functional Endoscopic Sinus Surgery performed during last 10 years in our ENT department. We analyzed endocranial complications, their causes, consequences, treatments and outcomes. Management was performed in collaboration with neurosurgeons and infectious diseases specialists. Results: Of 763 Functional Endoscopic Sinus Surgery procedures, we identified three cases with endocranial complications (0.393%). These complications included: a case of postoperative severe cerebrospinal fluid leak in a patient treated for severe polyposis;a case of cerebral-frontal abscess with delayed clinical manifestation (4 weeks post-surgery) in a patient treated for chronic pansinusitis who experienced difficult surgery for septal spur;and a case of pneumocephalus in a patient treated for allergic fungal sinusitis. The clinical outcome was favorable in all cases. Conclusions: Intra-operative cerebrospinal fluid leak, anatomical deformities (even minimal deformities) and massive inflammatory sinus disease are predisposing factors for endocranial complications with Functional Endoscopic Sinus Surgery. Prognosis can be favorable when therapeutic management is carried out in collaboration with neurosurgeons and infectious disease specialists.展开更多
BACKGROUND Pneumocephalus is a rare complication presenting in the postoperative period of a thoracoscopic operation.We report a case in which tension pneumocephalus occurred after thoracoscopic resection as well as t...BACKGROUND Pneumocephalus is a rare complication presenting in the postoperative period of a thoracoscopic operation.We report a case in which tension pneumocephalus occurred after thoracoscopic resection as well as the subsequent approach of surgical management.CASE SUMMARY A 66-year-old man who received thoracoscopic resection to remove an intrathoracic,posterior mediastinal,dumbbell-shaped,pathology-proven neurogenic tumor.The patient then reported experiencing progressively severe headaches,especially when in an upright position.A brain computed tomography scan at a local hospital disclosed extensive pneumocephalus.Revision surgery for resection of the pseudomeningocele and repair of the cerebrospinal fluid leakage was thus arranged for the patient.During the operation,we traced the cerebrospinal fluid leakage and found that it might have derived from incomplete endoscopic clipping around the tumor stump near the dural sac at the T3 level.After that,we wrapped and sealed all the possible origins of the leakage with autologous fat,tissue glue,gelfoam,and duraseal layer by layer.The patient recovered well,and the computed tomography images showed resolution of the pneumocephalus.CONCLUSION This report and literature review indicated that the risk of developing a tension pneumocephalus cannot be ignored and should be monitored carefully after thoracoscopic tumor resection.展开更多
Pneumocephalus is the presence of air in the cranial vault. The common etiologies of pneumocephalus are brain trauma and cranial surgery. We report a case of a 26-year-old man with brain trauma who developed diffuse p...Pneumocephalus is the presence of air in the cranial vault. The common etiologies of pneumocephalus are brain trauma and cranial surgery. We report a case of a 26-year-old man with brain trauma who developed diffuse pneumocephalus after sneezing. CT scan was performed on arrival, and the image showed subarach- noid hemolxhage without pneumocephalus. On the seventh day after a big sneeze brain CT scan was re-performed, which showed pneumocephalus. After another ten days of treatment, the patient was discharged without any symptoms.展开更多
文摘Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have reduced the frequency and severity of common complications, reports of rare and serious complications such as pneumocephalus, remain scarce. Case Report: This article presents a case of pneumocephalus following CSEA in a middle-aged female patient undergoing surgery for an intrauterine space-occupying lesion. The patient experienced severe headache postoperatively, and imaging confirmed the presence of intracranial air. After receiving active symptomatic treatment, the patient recovered and was discharged. Conclusion: This case underscores the importance of adhering to standard anesthesia protocols and increasing awareness of rare CSEA complications, particularly the risk of pneumocephalus. Early recognition and timely management are crucial. There is a need to further enhance training and research in anesthetic procedures to improve clinical anesthesia quality and ensure patient safety.
文摘Objective:To report a rare case of otogenic tension pneumocephalus as a complication of a diffuse leptomeningeal glioneuronal tumor in a patient with a ventriculoperitoneal(V.P.)shunt.Patients:Twenty-three-year-old man with a confirmed diffuse leptomeningeal glioneuronal tumor diagnosis was treated for temporal bone defect and considerable pneumocephalus one year after V.P.shunt.Intervention(s):The patient underwent a Transmastoid,retrolabyrinthine approach.The defect was closed with temporalis facia graft and conchal cartilage as a double-layer closure,and then DuraSeal®was placed over the repaired area.Main outcome measure(s):Resolution of the pneumocephalus.Results:There was a significant reduction in the pneumocephalus on the first day post-operatively.Conclusions:Spontaneous or secondary pneumocephalus development should be considered in patients with brain tumors,hydrocephalus,and patients who undergo V.P.shunt insertion.
文摘Pneumocephalus is an uncommon, often forgotten complication of meningitis caused by gas-producing organisms, especially in advanced aged patients. Attention should be paid to physical signs, and early computed tomography （CT） scan could be helpful in the diagnosis. Accurate antibiotics according to blood culture would be the key point in the treatment procedure.
文摘Objectives: We critically reviewed our experiences in endocranial complications with Functional Endoscopic Sinus Surgery, and investigated the causes, prevention strategies and management. Methods: We conducted a retrospective study of endocranial complications with Functional Endoscopic Sinus Surgery performed during last 10 years in our ENT department. We analyzed endocranial complications, their causes, consequences, treatments and outcomes. Management was performed in collaboration with neurosurgeons and infectious diseases specialists. Results: Of 763 Functional Endoscopic Sinus Surgery procedures, we identified three cases with endocranial complications (0.393%). These complications included: a case of postoperative severe cerebrospinal fluid leak in a patient treated for severe polyposis;a case of cerebral-frontal abscess with delayed clinical manifestation (4 weeks post-surgery) in a patient treated for chronic pansinusitis who experienced difficult surgery for septal spur;and a case of pneumocephalus in a patient treated for allergic fungal sinusitis. The clinical outcome was favorable in all cases. Conclusions: Intra-operative cerebrospinal fluid leak, anatomical deformities (even minimal deformities) and massive inflammatory sinus disease are predisposing factors for endocranial complications with Functional Endoscopic Sinus Surgery. Prognosis can be favorable when therapeutic management is carried out in collaboration with neurosurgeons and infectious disease specialists.
基金Supported by China Medical University Hospital(No.DMR-107-063).
文摘BACKGROUND Pneumocephalus is a rare complication presenting in the postoperative period of a thoracoscopic operation.We report a case in which tension pneumocephalus occurred after thoracoscopic resection as well as the subsequent approach of surgical management.CASE SUMMARY A 66-year-old man who received thoracoscopic resection to remove an intrathoracic,posterior mediastinal,dumbbell-shaped,pathology-proven neurogenic tumor.The patient then reported experiencing progressively severe headaches,especially when in an upright position.A brain computed tomography scan at a local hospital disclosed extensive pneumocephalus.Revision surgery for resection of the pseudomeningocele and repair of the cerebrospinal fluid leakage was thus arranged for the patient.During the operation,we traced the cerebrospinal fluid leakage and found that it might have derived from incomplete endoscopic clipping around the tumor stump near the dural sac at the T3 level.After that,we wrapped and sealed all the possible origins of the leakage with autologous fat,tissue glue,gelfoam,and duraseal layer by layer.The patient recovered well,and the computed tomography images showed resolution of the pneumocephalus.CONCLUSION This report and literature review indicated that the risk of developing a tension pneumocephalus cannot be ignored and should be monitored carefully after thoracoscopic tumor resection.
文摘Pneumocephalus is the presence of air in the cranial vault. The common etiologies of pneumocephalus are brain trauma and cranial surgery. We report a case of a 26-year-old man with brain trauma who developed diffuse pneumocephalus after sneezing. CT scan was performed on arrival, and the image showed subarach- noid hemolxhage without pneumocephalus. On the seventh day after a big sneeze brain CT scan was re-performed, which showed pneumocephalus. After another ten days of treatment, the patient was discharged without any symptoms.
