Postoperative air embolism caused by pneumatocephalus following occlusion of the posterior fossa. A rare complication indicative of a bridging vein disruption
Φόρτωση...
Ημερομηνία
Συγγραφείς
Papadopoulos, G.
Kuhly, P.
Brock, M.
Rudolph, K. H.
Link, J.
Eyrich, K.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
Anaesthesist
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
Many neurosurgeons prefer the sitting position for patients undergoing surgery in the posterior fossa because of the easier access and better conditions for haemostasis. Pneumatocephalus is a possible consequence of surgery in the posterior fossa with the patient in the sitting position. When this occurs air may enter the subarachnoid space, the cisternae, the ventricular system or the subdural space; it becomes more likely when any of the following is/are present: loss of CSF, a large cavity resulting from surgery, external or internal drainage of CSF, osmotic diuresis, and hyperventilation. Distances of 1-2 cm between cranium and brain may be found. The rupture of bridging veins may cause a subsequent subdural haematoma. Air embolism due to pneumatocephalus via the same vein after closure of the cranium is in this paper for the first time. Case report. A 37-year-old man with known Hippel-Lindau disease presented for posterior fossa surgery for treatment of a haemangioblastoma of the right cerebellar hemisphere. Surgery was done with the patient in a sitting position. Apart from one short episode of air embolism without haemodynamic changes no intraoperative complications occurred. After closure of the cranium and galea an unexpected and inexplicable air embolism of 10 min duration occurred again. TEE demonstrated the air looking like a string of beads in the right atrium. As complete skin had already been closure no explanation for the air embolism could be found. The patient was positioned supine, and air was no longer detectable in the right heart after 1 min. Approximately 1 h later both pupils were dilated and unreactive to light.(ABSTRACT TRUNCATED AT 250 WORDS)
Περιγραφή
Λέξεις-κλειδιά
Adult, Cerebellar Neoplasms/surgery, Cerebral Veins/injuries, Cranial Fossa, Posterior/surgery, Embolism, Air/etiology, Hemangioblastoma/surgery, Humans, Male, Pneumocephalus*etiology, Postoperative Complications
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/8214538
Γλώσσα
de
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής