• Ann Emerg Med · Oct 2010

    Case Reports

    Spontaneous tension pneumocephalus resulting from a scalp fistula in a patient with a remotely placed ventriculoperitoneal shunt.

    • Jessica Monas and David A Peak.
    • Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA. jmonas@partners.org
    • Ann Emerg Med. 2010 Oct 1;56(4):378-81.

    AbstractTension pneumocephalus is a life-threatening condition that requires rapid recognition and intervention. It usually occurs as an early postoperative complication after neurosurgery or after trauma. Delayed tension pneumocephalus after ventriculoperitoneal shunt placement is unusual, with fewer than 50 published case reports, and is rarely caused by a scalp defect. We present a patient with nontraumatic tension pneumocephalus caused by a scalp fistula from a remote ventriculoperitoneal shunt placed 5 years earlier. This case is unique in that the patient underwent percutaneous aspiration of the tension pneumocephalus as a lifesaving procedure in the emergency department, with complete resolution of her symptoms at 30-day follow-up.Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

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