Mount Fuji Sign Research Articles

Traumatic Tension Pneumocephalus with mount Fuji sign and air bubble sign

Introduction: Tension Pneumocephalus is a rare but a life threatening neurosurgical emergency which may need urgent surgical intervention. For diagnosis Brain imaging preferably Brain CT scan is mandatory. Case presentation: We present a rare case case of post traumatic tension Pneumocephalus in 40 years old man who sustained a road traffic accident. Brain CT scan shows Mount Fuji sign and air bubble sign, which are the typical signs of tension Pneumocephalus. Emergency burr-hole evacuation was carried out and after the procedure the patient was followed by control lateral skull X-ray and then discharged after 10 days of hospital Stay with GCS of 15. Conclusion: Tension Pneumocephalus is a clinical diagnosis. History with Brain Imaging can easily diagnose it but invasive surgical intervention may be Mandatory to overcome the problem. Knowledge of risk factors ,radiographic findings and clinical signs/symptoms associated with Tension Pneumocephalus is crucial to its Prompt identification and treatment.

Mount Fuji Sign: Pneumocephalus Following Burr-hole Evacuation of Subdural Hematoma

Mount Fuji Sign: Pneumocephalus Following Burr-hole Evacuation of Subdural Hematoma

Hemi Le Fort III Fracture with Subdural and Subarachnoid Pneumocephalus with a Mild Mount Fuji Sign

Hemi Le Fort III Fracture with Subdural and Subarachnoid Pneumocephalus with a Mild Mount Fuji Sign

Tension Pneumocephalus in a Posttraumatic Patient: Computed Tomographic Findings and Case Report

Tension pneumocephalus is an unusual bad life-threatening neurosurgical emergency, this is the equivalent of tension pneumothorax. This often follows head trauma, epidural injections, complicating neurological spinal, craniofacial or sinus surgery. This is a forty-five-year-old man that was involved in a road traffic accident, was referred for a computed tomography of the brain on account of altered consciousness, irrational behavior, and restlessness. A non-contrast enhanced computed tomography of the brain was done, this demonstrated multiple areas of cortical discontinuity in the facial and skull vaults in keeping with fractures, extensive negative density (HU: -968) hypodensity in the frontal region bilaterally causing marked inferior displacement of both frontal lobes of the brain, with associated splaying of the interhemispheric fissure likened to the ‘Mount Fuji sign’ of severe/tension pneumocephalus. Pockets of negative density hypodensities are also noted in both cerebral hemispheres in keeping with pneumatoceles are also demonstrated. Generalized effacement of sulci and gyri in keeping with cerebral edema is also demonstrated. The outcome of the patient in the peripheral center was not known as at the time of this report, because all effort to get across to the patient and relations proved abortive. We present a case of tension pneumocephalus following road transport accident, to review the computed tomographic features due to its peculiar presentation.

Trauma-Associated Tension Pneumocephalus with Characteristic Mount Fuji Sign—Case Report

AbstractTension pneumocephalus is a rare and life-threatening neurosurgical emergency in the setting of blunt or penetrating head trauma, especially in those with craniofacial fractures, which emergency physicians should be aware about. Early identification and appropriate treatment measures including supine positioning, 100% oxygen via mask, early neurosurgery consultation and, if required, operative intervention are paramount to optimal neurological and survival outcome. Definitive diagnosis requires imaging usually in the form of computed tomography (CT) head and serial monitoring of neurological status, optic nerve sheath diameter measurement and repeat imaging, essential to identify patients who might have features of increased pressure on brain matter, which could lead to adverse neurological and clinical outcomes. We present two cases of tension pneumocephalus with the characteristic Mount Fuji sign on CT head, who were managed nonoperatively with optimal neurological outcome. In patients with severe head or maxillofacial trauma presenting to emergency department, CT should be evaluated for signs of tension pneumocephalus, and such patients need to be closely observed for complications of pressure effect on brain matter to ensure optimal neurological and survival outcomes.

Expanding pneumocephalus due to craniofacial fractures: A case report.

IntroductionPneumocephalus (PNC) is the presence of air in the intracranial cavity. The most frequent cause is craniofacial trauma, though there are many etiologies, including surgical procedures. PNC with compression of the frontal lobes and widening of the interhemispheric space between the tips of the frontal lobes results in the characteristic radiological finding of the “Mount Fuji sign”.Presentation of caseA 57-year-old man presented to the A&E with loss of consciousness due to a motorcycle collision 9 h prior. He had a GCS of E4M6V5, and a head CT scan revealed minimal PNC forming in both hemispheres. After discharge, severe headaches and rhinorrhea developed. A second CT scan revealed a massive PNC. An operation was then performed via a bicoronal incision to drain the PNC and seal the cranial defect. A burr hole in the calvarium was created, and the cranial defect was closed using a pericranial rotational flap. Post-operation, the patient's headache and rhinorrhea decreased; neither symptom was present at 1-month post-operation. The wounds healed with minimal scarring, and the cosmetic outcome for the craniofacial fracture was acceptable.DiscussionAlthough the patient may at first present with a mild head injury, this can progress into something much more serious. PNC is difficult to diagnose clinically. Rarely, patients describe a splashing sound upon moving the head (termed bruit hydro-aerique), which can also be auscultated. A head CT scan is the gold standard in the diagnosis of PNC. Pericranial flaps are widely used for dural repair because they are easily accessible and have a lower rate of infection than artificial grafts on expanding PNC.ConclusionTension PNC may be slow-growing and increase intracranial pressure to high levels before clinical signs are present. The pericranial rotational flap technique is the best way to close a dura mater defect in cranial base fractures with tension PNC.

Unilateral pneumocephalus: A rare case

The aim of this paper is to share a rare finding that is unreported in any peer reviewed journal before to the best of our knowledge. Pneumocephalus is characterized by the classic “Mount Fuji” sign. This case will present a patient suffers from a frontal and nasal bone fracture on one side that caused a unilateral pneumocephalus. Keyword: Pneumocephalus; Mount Fuji Sign; Computed Tomography; Road Traffic Accident

Tension Pneumocephalus in a Tracheostomized, Chronically Ventilated, Duchenne’s Muscular Dystrophy Patient Without Prior Head Trauma

Tension pneumocephalus is a rare condition that can be a life-threatening neurosurgical emergency. It usually results from head trauma, but there have been case reports of iatrogenic causes including on non-invasive mechanical ventilation. We report a case of pneumocephalus resulting from high mechanical ventilation pressures in a patient without prior head trauma.A 37-year-old male with Duchenne’s muscular dystrophy who had been ventilator-dependent through tracheostomy was admitted for shortness of breath and intermittent fevers. The patient was found to have pneumonia, with left-lower lobe consolidation, and was started on linezolid given known Methicillin-resistant Staphylococcus aureus from previous sputum culture; he was later switched to vancomycin and piperacillin-tazobactam given persistent fevers to cover for hospital-acquired pneumonia. The patient went into septic shock requiring multiple pressors as well as stress steroids for persistent shock, with eventual improvement in hemodynamics. He developed further respiratory acidosis on his usual ventilator settings, and peak inspiratory pressures (PIPs) progressively increased to as high as 45-70 cm H2O during his hospital course. PIPs did not improve with suctioning or after bronchoscopy. On the 17th day of the patient’s stay, he had acutely altered mental status with non-reactive fixed and dilated pupils and disconjugate gaze of the right eye on neurologic examination. CT of the head at that time revealed extensive pneumocephalus along the bifrontal convexities, suprasellar cisterns, and posterior fossa, with a possible fracture of the frontal skull base near the ethmoid roof. Mount Fuji sign was present on CT scan, indicative of “tension pneumocephalus”. Neurosurgical consultation was obtained but the family declined intervention given his overall debilitated stated. Comfort measures were instituted, and the patient expired the following day.Pneumocephalus is the accumulation of air entry into the cranial cavity, generally from head trauma, inflammation, or surgery. Patients may have underlying base skull defects or microfractures that permit air to enter the intracranial cavity. Increased sphenoid sinus pressure from mechanical ventilation may enter the subperiosteal space, allowing air to enter the intracranial cavity. It is important to consider pneumocephalus in a patient with new neurological findings after mechanical ventilation.

Post Craniotomy Late Fuji Mountain Pneumocephalus: Case Report

Introduction: Tension pneumocephalus is a neurosurgical emergency that occurs when subdural air causes a mass-effect over the underlying brain parenchyma. It is often termed the Mount Fuji sign due to an anticipated similarity with an iconic mountain peak in Japan. Case Presentation: We describe an 83-year-old woman with loss of consciousness, severe dizziness, nausea, and vomiting symptoms 20 days after a craniotomy. Conclusions: In this case report we discuss imaging and management of tension pneumocephalus.

Mount Fuji Sign: Tension Pneumocephalus in the Emergency Department.

A 59-year-old man with a history of Graves' disease and diabetes presented to our emergency department with complaints of headache and vomiting. He had undergone surgical orbital decompression of his left eye for Graves' exophthalmos the previous day. On examination, the patient was somnolent with fixed-gaze palsy in his left eye. Pupils were reactive bilaterally. His vitals were unremarkable. The patient's computed tomography (CT) images are shown in Figures 1 and 2.

Tension Pneumocephalus from Endoscopic Endonasal Surgery: A Case Series and Literature Review

Background: Tension pneumocephalus (TP) caused by endoscopic endonasal surgery is a serious complication. We report 4 cases of TP caused by endoscopic surgery and review other cases in the literature, with special attention given to the symptoms, imaging manifestations, therapeutic approaches. Methods: We performed a retrospective chart review of patients with TP caused by endoscopic surgery in our institution from 2015 to 2018. Additionally, the MEDLINE database was searched for all case series or reports of TP caused by endoscopic surgery. Findings: Seventeen articles were identified for review, including the 4 cases from the authors' institution. Ultimately, a total of 25 cases were included in this study. The main symptoms of TP were headache and change in mental status. Cerebrospinal fluid (CSF) leakage was reported in 21 patients (21/25, 84.0%). Eight patients (8/25, 32.0%) presented with the Mount Fuji sign imaging characteristic. Twenty-three patients were treated with surgical intervention for TP (endoscopic multilayer closure of skull base defect, cranial burr hole, bifrontal craniotomy). In addition, we first reported that 2 patients with TP were successfully given conservative treatment. Interpretation: The therapeutic method of TP should depend on the degree of the mass effect and clinical symptoms. When patients with TP presented with obvious symptoms of CSF leakage and intracranial hypertension, urgent surgical multilayer repair of the skull base defects or/and release of the intracranial pressure were the keys to treating these patients. However, conservative treatment under close observation was also feasible when the related symptoms were not obvious. Funding Statement: This work was financially supported by the National Natural Science Foundation of China (No. 81870703). Declaration of Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Ethical Approval Statement: This study was approved by the Institutional Review Board of AEENTH at Fudan University.

Sensitivity of the Mount Fuji Sign After Evacuation of Chronic Subdural Hematoma in Nonagenarians.

The Mount Fuji sign (MFS) is a radiological sign on computed tomographic scans depicting air between the frontal lobes. Air in this location indicates tension pneumocephalus (TP), considered a neurosurgical emergency.We evaluate the correlation between the MFS and perioperative mortality attributed to TP in nonagenarians who have undergone evacuation of chronic subdural hemorrhage (cSDH). We retrospectively reviewed the records of nonagenarians who had cSDH evacuation between 2006 and 2015. Postoperative computed tomographic images were evaluated for findings consistent with the MFS. Of 45 patients, 15 patients (33%) had radiological MFS, and 3 patients (20%) with MFS required reoperation because of new blood collection. No patient required reoperation because of TP. Perioperative (30-day) mortality in patients demonstrating the MFS was 6.67% caused by cardiac arrhythmia versus 13.33% mortality in patients with no evidence of the MFS. Mount Fuji sign in nonagenarians after cSDH evacuation is not a specific sign of TP.

Penetrating injury to the maxilla and skull base resulting in the mount fuji sign of tension pneumocephalus and ipsilateral vision loss

Pneumocephalus is defined as the presence of intracranial air seen most commonly secondary to a traumatic head injury. Tension pneumocephalus is often termed in radiology as the Mount Fuji sign due to a perceived similarity with the iconic mountain peak in Japan. We present the case of a 62-year-old gentleman who presented to the emergency department following a penetrating injury to the right maxilla and skull base which resulted in acute-onset ipsilateral vision loss due to direct traumatic injury to the optic nerve by the fractured bone fragments encountered in the optic canal.

A case of tension pneumocephalus with Mount Fuji sign

Abstract not availableBangladesh Crit Care J March 2018; 6(1): 57-59

Tension Pneumocephalus with Mount Fuji Sign

The 81-year-old male presented with progressive headache and was diagnosed as bilateral chronic subdural hemorrhage (SDH). He has history of hypertension, coronary artery disease and hyperlipidemia. Burr-hole craniostomy for removal of SDH was performed. However, deteriorated consciousness and seizure happened after removal of bilateral external ventricular drainage (EVD) on postoperative Day 3. The brain computed tomography (CT) scan showed bilateral tension pneumocephalus with significant mass effect and Mount Fuji sign. The patient underwent an emergency burr hole operation and the insertion of bilateral EVD. During the operation, the air bubbled out when the dura was opened. The patient’s consciousness subsequently improved and postoperative CT imaging showed considerable reduction in the pneumocephalus with relieved mass effect. Finally, the patient discharged with recovery neurological condition on the admission Day 11.

Using Mount Fuji for diagnosis of tension pneumocephalus

Not available.

A Patient with Massive Pneumocephalus without Sign of Tension Pneumocephalus

Background: Pneumocephalus is an injury that characterized by air entrance into the intracranial space. It may occur after head trauma, infection, tumor or it may be iatrogenic. According to the amount of air increases, this can cause neurological findings with a mass effect and this condition is called tension pneumocephalus. Case report: In this study present a case of a 63 year old man presented to the emergency department by EMS because of head trauma. He was found to have loss of consciousness. Brain CT-scan revealed the typical Mount Fuji sign suggestive of massive pneumocephalus. The patient was transferred to the ICU and was managed conservatively without any decompressive surgery. On evaluation of 5 days later, he was alert and asymptomatic and control brain CT-scan has minimal pneumocephalus. Then, the patient was discharged from hospital. Conclusion: Although massive pneumocephalus is a complication that if it is not treated immediately, it may be convert to tension pneumocephalus and give rise to serious morbidity and mortality concerns, but this case showed massive pneumocephalus without sign of tension pneumocephalus that conservative treatment was done successfully.

A Patient with Massive Pneumocephalus without Sign of Tension Pneumocephalus

Background: Pneumocephalus is an injury that characterized by air entrance into the intracranial space. It may occur after head trauma, infection, tumor or it may be iatrogenic. According to the amount of air increases, this can cause neurological findings with a mass effect and this condition is called tension pneumocephalus. Case report: In this study present a case of a 63 year old man presented to the emergency department by EMS because of head trauma. He was found to have loss of consciousness. Brain CT-scan revealed the typical Mount Fuji sign suggestive of massive pneumocephalus. The patient was transferred to the ICU and was managed conservatively without any decompressive surgery. On evaluation of 5 days later, he was alert and asymptomatic and control brain CT-scan has minimal pneumocephalus. Then, the patient was discharged from hospital. Conclusion: Although massive pneumocephalus is a complication that if it is not treated immediately, it may be convert to tension pneumocephalus and give rise to serious morbidity and mortality concerns, but this case showed massive pneumocephalus without sign of tension pneumocephalus that conservative treatment was done successfully.

Tension Pneumocephalus in Head Injury

Occurrence of pneumocephalus following a head trauma is relatively rare. Tension pneumocephalus can manifest as severe headache, dizziness, mental changes, and even seizure; therefore, urgent diagnosis and treatment are mandatory. The Mount Fuji sign on CT scans of the brain is useful in discriminating tension pneumocephalus from nontension pneumocephalus. Deterioration due to an increase in subdural air volume can be evacuated by craniotomy. Though uncommon, tension pneumocephalus is a life-threatening complication that requires urgent diagnosis and treatment.

Mount Fuji sign following surgical drainage of spinal epidural abscess: Figure 1.

A 56-year-old male was admitted to the emergency department with complaints of fever, shortness of breath. The patient’s medical history included laryngectomy due to laryngeal cancer. He was found to have an anterior epidural abscess at C7–C8 and underwent surgical drainage. Four days later, he developed marked weakness of both legs. He deteriorated and neeeded intubation and ventilation due to progressive decrease in his level of consciousness. Computer tomography (CT) of the brain demonstrated an extensive pneumocephalus causing a mass …