Abstract
Pneumocephalus after craniotomy will absorb within four weeks, but when air causes pressure affects it is a tension pneumocephalus, which may affect consciousness and requires immediate intervention. Tension pneumocephalus causing cerebral sinus thrombosis is not known in the literature. We report a case of tension pneumocephalus causing diabetes insipidus associated with cerebral sinus thrombosis.
Highlights
In our patient tension pneumocephalus was complicated by diabetes insipidus and leading to cerebral sinus thrombosis after surgery
Pneumocephalus is a common finding after craniotomy [1], but tension pneumocephalus is an acute neurosurgical emergency associated with increased intracranial pressure and neurological deterioration [2]
We report a case of tension pneumocephalus causing diabetes insipidus and cerebral sinus thrombosis
Summary
Pneumocephalus is a common finding after craniotomy [1], but tension pneumocephalus is an acute neurosurgical emergency associated with increased intracranial pressure and neurological deterioration [2]. He was admitted to the surgical intensive care unit (SICU) for observation. Temperature was controlled with paracetamol and a cooling device (Arctic Sun®, Medivance, Louisville, CO) He remained poyluric for 8 hours, serum sodium was elevated to 164 mmol.l-1 with low urinary specific gravity (1.005). He was diagnosed with diabetes insipidus and received desmopressin 4 μg intravenously. Immediate CT had demonstrated hydrocephalus, the extra ventricular drain was reinserted, but his pupils became fixed and dilated with absent brainstem reflexes. He was declared brain death on the third day after surgery
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