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Review of the management of pneumocephalus.

Dabdoub CB, Salas G, Silveira Edo N, Dabdoub CF - Surg Neurol Int (2015)

Bottom Line: Control CT scan demonstrated reduction of the intracranial air with normal brain parenchyma.There are a few cases reported of patients with Mount Fuji signs that do not require surgical procedures.The conservative treatment in our report leads to clinical and radiological improvement as well as a reduction in hospitalization time.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Campo Limpo Municipal Hospital, São Paulo, Brasil.

ABSTRACT

Background: Pneumocephalus (PNC) is the presence of air in the intracranial cavity. The most frequent cause is trauma, but there are many other etiological factors, such as surgical procedures. PNC with compression of frontal lobes and the widening of the interhemispheric space between the tips of the frontal lobes is a characteristic radiological finding of the "Mount Fuji sign." In addition to presenting our own case, we reviewed the most relevant clinical features, diagnostic methods, and conservative management for this condition.

Case description: A 74-year-old male was diagnosed with meningioma of olfactory groove several years ago. After no improvement, surgery of the left frontal craniotomy keyhole type was conducted. A computed tomography (CT) scan of the skull performed 24 h later showed a neuroimaging that it is described as the silhouette of Mount Fuji. The treatment was conservative and used continuous oxygen for 5 days. Control CT scan demonstrated reduction of the intracranial air with normal brain parenchyma.

Conclusion: The review of the literature, we did not find any cases of tension pneumocephalus documented previously through a supraorbital keyhole approach. There are a few cases reported of patients with Mount Fuji signs that do not require surgical procedures. The conservative treatment in our report leads to clinical and radiological improvement as well as a reduction in hospitalization time.

No MeSH data available.


Related in: MedlinePlus

Fuji Volcano in Japan (available from internet)
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Figure 1: Fuji Volcano in Japan (available from internet)

Mentions: The terms pneumocephalus (PNC) and tension pneumocephalus (TP) were created by Wolff[34] and Ectors,[8] respectively, even though TP has been described in the early literature.[6] PNC is the presence of air within the intracranial cavity. When this circumstance causes increased intracranial pressure that leads to neurological deterioration, it is known as TP. Ishiwata et al.[12] described the image produced by PNC in subdural collections that separated both frontal lobes as similar in appearance to the silhouette of the famous Fuji Volcano in Japan [Figure 1]. In this report, we present a case with a Mount Fuji sign after the evacuation of an olfactory groove meningioma through a supraorbital keyhole approach along with a short review of the literature.


Review of the management of pneumocephalus.

Dabdoub CB, Salas G, Silveira Edo N, Dabdoub CF - Surg Neurol Int (2015)

Fuji Volcano in Japan (available from internet)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4596054&req=5

Figure 1: Fuji Volcano in Japan (available from internet)
Mentions: The terms pneumocephalus (PNC) and tension pneumocephalus (TP) were created by Wolff[34] and Ectors,[8] respectively, even though TP has been described in the early literature.[6] PNC is the presence of air within the intracranial cavity. When this circumstance causes increased intracranial pressure that leads to neurological deterioration, it is known as TP. Ishiwata et al.[12] described the image produced by PNC in subdural collections that separated both frontal lobes as similar in appearance to the silhouette of the famous Fuji Volcano in Japan [Figure 1]. In this report, we present a case with a Mount Fuji sign after the evacuation of an olfactory groove meningioma through a supraorbital keyhole approach along with a short review of the literature.

Bottom Line: Control CT scan demonstrated reduction of the intracranial air with normal brain parenchyma.There are a few cases reported of patients with Mount Fuji signs that do not require surgical procedures.The conservative treatment in our report leads to clinical and radiological improvement as well as a reduction in hospitalization time.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Campo Limpo Municipal Hospital, São Paulo, Brasil.

ABSTRACT

Background: Pneumocephalus (PNC) is the presence of air in the intracranial cavity. The most frequent cause is trauma, but there are many other etiological factors, such as surgical procedures. PNC with compression of frontal lobes and the widening of the interhemispheric space between the tips of the frontal lobes is a characteristic radiological finding of the "Mount Fuji sign." In addition to presenting our own case, we reviewed the most relevant clinical features, diagnostic methods, and conservative management for this condition.

Case description: A 74-year-old male was diagnosed with meningioma of olfactory groove several years ago. After no improvement, surgery of the left frontal craniotomy keyhole type was conducted. A computed tomography (CT) scan of the skull performed 24 h later showed a neuroimaging that it is described as the silhouette of Mount Fuji. The treatment was conservative and used continuous oxygen for 5 days. Control CT scan demonstrated reduction of the intracranial air with normal brain parenchyma.

Conclusion: The review of the literature, we did not find any cases of tension pneumocephalus documented previously through a supraorbital keyhole approach. There are a few cases reported of patients with Mount Fuji signs that do not require surgical procedures. The conservative treatment in our report leads to clinical and radiological improvement as well as a reduction in hospitalization time.

No MeSH data available.


Related in: MedlinePlus