Journal of computer assisted tomography
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A clinical computed tomographic (CT) study of six patients, two with tension and four with benign postoperative subdural pneumocephalus, was done coupled with a data analysis of the literature. The mass effect of a tension subdural pneumatoma was demonstrable as shift in the midline structures when the air was unilateral, whereas an asymptomatic pneumocephalus showed no actual mass effect. ⋯ Of 21 reported cases of postsurgical tension pneumocephalus, 18 (86%) had the pneumatoma in the subdural space. The predisposing neurosurgical conditions to tension pneumatoma included: (a) a preexisting open cerebrospinal fluid drainage device; (b) surgery on the posterior fossa in the sitting position; and (c) chronic subdural hematoma.