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Outcome of Posttraumatic Delayed Intracerebral Tension Pneumatocele: Prospective Study of Four Cases: Single Institutional Experience

AIM: Delayed intracerebral tension pneumatocele (DITP) is an uncommon cause of raised intracranial pressure following trauma. However, it can cause herniation syndrome due to a sudden increase in intracranial pressure which requires emergent intervention. Pneumocephalus is a complication of head inj...

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Autores principales: Kankane, Vivek Kumar, Gupta, Tarun Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208253/
https://www.ncbi.nlm.nih.gov/pubmed/30459874
http://dx.doi.org/10.4103/ajns.AJNS_226_17
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author Kankane, Vivek Kumar
Gupta, Tarun Kumar
author_facet Kankane, Vivek Kumar
Gupta, Tarun Kumar
author_sort Kankane, Vivek Kumar
collection PubMed
description AIM: Delayed intracerebral tension pneumatocele (DITP) is an uncommon cause of raised intracranial pressure following trauma. However, it can cause herniation syndrome due to a sudden increase in intracranial pressure which requires emergent intervention. Pneumocephalus is a complication of head injury in 3.9%–9.7% of the cases. The accumulation of intracranial air can be acute (<72 h) or delayed (≥72 h). METHOD: When intracranial air causes intracranial hypertension and has a mass effect with neurological deterioration, it is called tension pneumocephalus. In our case series, we demonstrated four cases of DITP in adult patients from January 2012 to January 2017 in the Department of Neurosurgery at R. N. T. Medical College and M. B. Hospital, Udaipur, Rajasthan. RESULT: During this period, a total number of patients admitted of head injury are 1768 and hence, the incidence of DITP in our series is 0.226% which is very less as compared to previous literature. All patients are male; age ranging from 17 years to 55 years (mean age was 31.75 years). All patients have a history of head injury, and mode of injury had road traffic accidents. Glasgow Coma Score (GCS) at readmission were 12–13 (mean GCS 12.75). Duration of developed DITP 1 month to 2½ months (mean 1.375 months), all patients had gone to surgical intervention, and outcome assessed using Glasgow outcome score. All patients had a good outcome and average follow-up was 12.5 months. CONCLUSION: long term observation of patients with simple pneumocephalus following trauma is beneficial as there is an expected risk of developing delayed tension pneumocephalus which may manifest with raised intracranial pressure.
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spelling pubmed-62082532018-11-20 Outcome of Posttraumatic Delayed Intracerebral Tension Pneumatocele: Prospective Study of Four Cases: Single Institutional Experience Kankane, Vivek Kumar Gupta, Tarun Kumar Asian J Neurosurg Original Article AIM: Delayed intracerebral tension pneumatocele (DITP) is an uncommon cause of raised intracranial pressure following trauma. However, it can cause herniation syndrome due to a sudden increase in intracranial pressure which requires emergent intervention. Pneumocephalus is a complication of head injury in 3.9%–9.7% of the cases. The accumulation of intracranial air can be acute (<72 h) or delayed (≥72 h). METHOD: When intracranial air causes intracranial hypertension and has a mass effect with neurological deterioration, it is called tension pneumocephalus. In our case series, we demonstrated four cases of DITP in adult patients from January 2012 to January 2017 in the Department of Neurosurgery at R. N. T. Medical College and M. B. Hospital, Udaipur, Rajasthan. RESULT: During this period, a total number of patients admitted of head injury are 1768 and hence, the incidence of DITP in our series is 0.226% which is very less as compared to previous literature. All patients are male; age ranging from 17 years to 55 years (mean age was 31.75 years). All patients have a history of head injury, and mode of injury had road traffic accidents. Glasgow Coma Score (GCS) at readmission were 12–13 (mean GCS 12.75). Duration of developed DITP 1 month to 2½ months (mean 1.375 months), all patients had gone to surgical intervention, and outcome assessed using Glasgow outcome score. All patients had a good outcome and average follow-up was 12.5 months. CONCLUSION: long term observation of patients with simple pneumocephalus following trauma is beneficial as there is an expected risk of developing delayed tension pneumocephalus which may manifest with raised intracranial pressure. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6208253/ /pubmed/30459874 http://dx.doi.org/10.4103/ajns.AJNS_226_17 Text en Copyright: © 2018 Asian Journal of Neurosurgery http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Kankane, Vivek Kumar
Gupta, Tarun Kumar
Outcome of Posttraumatic Delayed Intracerebral Tension Pneumatocele: Prospective Study of Four Cases: Single Institutional Experience
title Outcome of Posttraumatic Delayed Intracerebral Tension Pneumatocele: Prospective Study of Four Cases: Single Institutional Experience
title_full Outcome of Posttraumatic Delayed Intracerebral Tension Pneumatocele: Prospective Study of Four Cases: Single Institutional Experience
title_fullStr Outcome of Posttraumatic Delayed Intracerebral Tension Pneumatocele: Prospective Study of Four Cases: Single Institutional Experience
title_full_unstemmed Outcome of Posttraumatic Delayed Intracerebral Tension Pneumatocele: Prospective Study of Four Cases: Single Institutional Experience
title_short Outcome of Posttraumatic Delayed Intracerebral Tension Pneumatocele: Prospective Study of Four Cases: Single Institutional Experience
title_sort outcome of posttraumatic delayed intracerebral tension pneumatocele: prospective study of four cases: single institutional experience
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208253/
https://www.ncbi.nlm.nih.gov/pubmed/30459874
http://dx.doi.org/10.4103/ajns.AJNS_226_17
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