Incidence and perioperative management of tension pneumocephalus following craniofacial resection.

Journal Article (Journal Article)

This study is a retrospective review to evaluate factors associated with the risk of pneumocephalus following craniofacial resection and the management of tension pneumocephalus. Twenty-two craniofacial operative procedures were reviewed in 18 patients entered into the Neurosciences Critical Care Unit, Johns Hopkins Hospital, during a 54 month period, from 1986-1991. Pneumocephalus developed after 7 of 22 operations; of these seven, two developed tension pneumocephalus. The use of lumbar cerebral spinal fluid (CSF) drainage during the operation correlated most strongly with the development of pneumocephalus. The diagnosis of esthesioblastoma also correlated significantly. Both episodes of tension pneumocephalus occurred after craniofacial resection in which lumbar drainage of CSF was performed. Tension pneumocephalus was successfully treated in these two patients with a combination of air evacuation and medical management of raised intracranial pressure. Transient diabetes insipidus developed in both patients. The risk of pneumocephalus following craniofacial procedures is significant, and may be increased by the use of lumbar drainage of CSF intraoperatively. Rapid neurologic deterioration following craniofacial resection may be caused by the development of tension pneumocephalus. Early diagnosis of tension pneumocephalus and aggressive management of raised intracranial pressure may be important in preventing serious neurological complications.

Full Text

Duke Authors

Cited Authors

  • Yates, H; Hamill, M; Borel, CO; Toung, TJ

Published Date

  • January 1994

Published In

Volume / Issue

  • 6 / 1

Start / End Page

  • 15 - 20

PubMed ID

  • 8298259

International Standard Serial Number (ISSN)

  • 0898-4921

Digital Object Identifier (DOI)

  • 10.1097/00008506-199401000-00002


  • eng

Conference Location

  • United States