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Tension pneumocephalus following endoscopic resection of a mediastinal thoracic spinal tumor: A case report

BACKGROUND: Pneumocephalus is a rare complication presenting in the postoperative period of a thoracoscopic operation. We report a case in which tension pneumocephalus occurred after thoracoscopic resection as well as the subsequent approach of surgical management. CASE SUMMARY: A 66-year-old man wh...

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Autores principales: Chang, Chao-Yuan, Hung, Cheng-Che, Liu, Ju-Mien, Chiu, Cheng-Di
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8771397/
https://www.ncbi.nlm.nih.gov/pubmed/35097100
http://dx.doi.org/10.12998/wjcc.v10.i2.725
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author Chang, Chao-Yuan
Hung, Cheng-Che
Liu, Ju-Mien
Chiu, Cheng-Di
author_facet Chang, Chao-Yuan
Hung, Cheng-Che
Liu, Ju-Mien
Chiu, Cheng-Di
author_sort Chang, Chao-Yuan
collection PubMed
description BACKGROUND: Pneumocephalus is a rare complication presenting in the postoperative period of a thoracoscopic operation. We report a case in which tension pneumocephalus occurred after thoracoscopic resection as well as the subsequent approach of surgical management. CASE SUMMARY: A 66-year-old man who received thoracoscopic resection to remove an intrathoracic, posterior mediastinal, dumbbell-shaped, pathology-proven neurogenic tumor. The patient then reported experiencing progressively severe headaches, especially when in an upright position. A brain computed tomography scan at a local hospital disclosed extensive pneumocephalus. Revision surgery for resection of the pseudomeningocele and repair of the cerebrospinal fluid leakage was thus arranged for the patient. During the operation, we traced the cerebrospinal fluid leakage and found that it might have derived from incomplete endoscopic clipping around the tumor stump near the dural sac at the T3 level. After that, we wrapped and sealed all the possible origins of the leakage with autologous fat, tissue glue, gelfoam, and duraseal layer by layer. The patient recovered well, and the computed tomography images showed resolution of the pneumocephalus. CONCLUSION: This report and literature review indicated that the risk of developing a tension pneumocephalus cannot be ignored and should be monitored carefully after thoracoscopic tumor resection.
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spelling pubmed-87713972022-01-28 Tension pneumocephalus following endoscopic resection of a mediastinal thoracic spinal tumor: A case report Chang, Chao-Yuan Hung, Cheng-Che Liu, Ju-Mien Chiu, Cheng-Di World J Clin Cases Case Report BACKGROUND: Pneumocephalus is a rare complication presenting in the postoperative period of a thoracoscopic operation. We report a case in which tension pneumocephalus occurred after thoracoscopic resection as well as the subsequent approach of surgical management. CASE SUMMARY: A 66-year-old man who received thoracoscopic resection to remove an intrathoracic, posterior mediastinal, dumbbell-shaped, pathology-proven neurogenic tumor. The patient then reported experiencing progressively severe headaches, especially when in an upright position. A brain computed tomography scan at a local hospital disclosed extensive pneumocephalus. Revision surgery for resection of the pseudomeningocele and repair of the cerebrospinal fluid leakage was thus arranged for the patient. During the operation, we traced the cerebrospinal fluid leakage and found that it might have derived from incomplete endoscopic clipping around the tumor stump near the dural sac at the T3 level. After that, we wrapped and sealed all the possible origins of the leakage with autologous fat, tissue glue, gelfoam, and duraseal layer by layer. The patient recovered well, and the computed tomography images showed resolution of the pneumocephalus. CONCLUSION: This report and literature review indicated that the risk of developing a tension pneumocephalus cannot be ignored and should be monitored carefully after thoracoscopic tumor resection. Baishideng Publishing Group Inc 2022-01-14 2022-01-14 /pmc/articles/PMC8771397/ /pubmed/35097100 http://dx.doi.org/10.12998/wjcc.v10.i2.725 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Case Report
Chang, Chao-Yuan
Hung, Cheng-Che
Liu, Ju-Mien
Chiu, Cheng-Di
Tension pneumocephalus following endoscopic resection of a mediastinal thoracic spinal tumor: A case report
title Tension pneumocephalus following endoscopic resection of a mediastinal thoracic spinal tumor: A case report
title_full Tension pneumocephalus following endoscopic resection of a mediastinal thoracic spinal tumor: A case report
title_fullStr Tension pneumocephalus following endoscopic resection of a mediastinal thoracic spinal tumor: A case report
title_full_unstemmed Tension pneumocephalus following endoscopic resection of a mediastinal thoracic spinal tumor: A case report
title_short Tension pneumocephalus following endoscopic resection of a mediastinal thoracic spinal tumor: A case report
title_sort tension pneumocephalus following endoscopic resection of a mediastinal thoracic spinal tumor: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8771397/
https://www.ncbi.nlm.nih.gov/pubmed/35097100
http://dx.doi.org/10.12998/wjcc.v10.i2.725
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AT liujumien tensionpneumocephalusfollowingendoscopicresectionofamediastinalthoracicspinaltumoracasereport
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