[Subdural tension pneumocephalus following surgery of chronic subdural hematoma]. 1987

Y Ishiwata, and H Fujino, and T Kubokura, and K Tsubone, and T Sekino, and K Fujitsu

Subdural tension pneumocephalus (TP) following surgery for chronic subdural hematoma was analyzed in 5 cases from clinical standpoints of view, especially from CT findings. The cases were compared with 14 cases of subdural asymptomatic pneumocephalus (AP). The TP tends to complicate elderly patients who showed a poor re-expansion of the brain after irrigation of bilateral chronic subdural hematoma. In such patients, it is difficult to make an exact diagnosis of TP because of residual mass effect of the evacuated hematoma. Significance of mass effect caused by subdural air has been discussed in the literature only little. In this study, we found two new CT findings suggesting increased tension of subdural air. First, the subdural tensive air separates and compresses the frontal lobes. The compressed frontal lobes with widened interhemispheric space between the frontal poles mimic the silhouette of Mt. Fuji. We called this CT finding "Mt. Fuji" sign. The presence of air between the frontal poles associated with massive air over the frontal lobes presumably indicates an increased tension of the subdural air. "Mt. Fuji" sign was seen in 4 cases out of 5 TP cases. Another sign is the presence of multiple small air bubbles in the subarachnoid space, especially in the cisterns. We proposed that these air bubbles were trapped in the subarachnoid space through a tear of the arachnoid membrane which is caused by increased tension of air in the subdural space. This finding was present in 4 cases with TP. We emphasize that these two CT signs are helpful to make an accurate diagnosis of TP following surgery for chronic subdural hematoma.

UI MeSH Term Description Entries
D008297 Male Males
D011007 Pneumocephalus Presence of air or gas within the intracranial cavity (e.g., epidural space, subdural space, intracerebral, etc.) which may result from traumatic injuries, fistulous tract formation, erosions of the skull from NEOPLASMS or infection, NEUROSURGICAL PROCEDURES, and other conditions. Cranial Pneumocyst,Intracranial Gas,Pneumocephalus, Tension,Cranial Airocele,Pneumocephalus, Epidural,Pneumocephalus, Traumatic,Pressure Pneumocephalus,Airocele, Cranial,Airoceles, Cranial,Cranial Airoceles,Cranial Pneumocysts,Epidural Pneumocephalus,Gas, Intracranial,Pneumocephalus, Pressure,Pneumocyst, Cranial,Pneumocysts, Cranial,Tension Pneumocephalus,Traumatic Pneumocephalus
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D005260 Female Females
D006408 Hematoma, Subdural Accumulation of blood in the SUBDURAL SPACE between the DURA MATER and the arachnoidal layer of the MENINGES. This condition primarily occurs over the surface of a CEREBRAL HEMISPHERE, but may develop in the spinal canal (HEMATOMA, SUBDURAL, SPINAL). Subdural hematoma can be classified as the acute or the chronic form, with immediate or delayed symptom onset, respectively. Symptoms may include loss of consciousness, severe HEADACHE, and deteriorating mental status. Hemorrhage, Subdural,Subdural Hematoma,Subdural Hematoma, Traumatic,Hematoma, Traumatic Subdural,Hematomas, Subdural,Hematomas, Traumatic Subdural,Hemorrhages, Subdural,Subdural Hematomas,Subdural Hematomas, Traumatic,Subdural Hemorrhage,Subdural Hemorrhages,Traumatic Subdural Hematoma,Traumatic Subdural Hematomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D014057 Tomography, X-Ray Computed Tomography using x-ray transmission and a computer algorithm to reconstruct the image. CAT Scan, X-Ray,CT Scan, X-Ray,Cine-CT,Computerized Tomography, X-Ray,Electron Beam Computed Tomography,Tomodensitometry,Tomography, Transmission Computed,X-Ray Tomography, Computed,CAT Scan, X Ray,CT X Ray,Computed Tomography, X-Ray,Computed X Ray Tomography,Computerized Tomography, X Ray,Electron Beam Tomography,Tomography, X Ray Computed,Tomography, X-Ray Computer Assisted,Tomography, X-Ray Computerized,Tomography, X-Ray Computerized Axial,Tomography, Xray Computed,X Ray Computerized Tomography,X Ray Tomography, Computed,X-Ray Computer Assisted Tomography,X-Ray Computerized Axial Tomography,Beam Tomography, Electron,CAT Scans, X-Ray,CT Scan, X Ray,CT Scans, X-Ray,CT X Rays,Cine CT,Computed Tomography, Transmission,Computed Tomography, X Ray,Computed Tomography, Xray,Computed X-Ray Tomography,Scan, X-Ray CAT,Scan, X-Ray CT,Scans, X-Ray CAT,Scans, X-Ray CT,Tomographies, Computed X-Ray,Tomography, Computed X-Ray,Tomography, Electron Beam,Tomography, X Ray Computer Assisted,Tomography, X Ray Computerized,Tomography, X Ray Computerized Axial,Transmission Computed Tomography,X Ray Computer Assisted Tomography,X Ray Computerized Axial Tomography,X Ray, CT,X Rays, CT,X-Ray CAT Scan,X-Ray CAT Scans,X-Ray CT Scan,X-Ray CT Scans,X-Ray Computed Tomography,X-Ray Computerized Tomography,Xray Computed Tomography

Related Publications

Y Ishiwata, and H Fujino, and T Kubokura, and K Tsubone, and T Sekino, and K Fujitsu
June 1980, The Journal of trauma,
Y Ishiwata, and H Fujino, and T Kubokura, and K Tsubone, and T Sekino, and K Fujitsu
August 1985, No shinkei geka. Neurological surgery,
Y Ishiwata, and H Fujino, and T Kubokura, and K Tsubone, and T Sekino, and K Fujitsu
October 1982, Journal of computer assisted tomography,
Y Ishiwata, and H Fujino, and T Kubokura, and K Tsubone, and T Sekino, and K Fujitsu
February 1984, No to shinkei = Brain and nerve,
Y Ishiwata, and H Fujino, and T Kubokura, and K Tsubone, and T Sekino, and K Fujitsu
January 1987, Pediatric neurology,
Y Ishiwata, and H Fujino, and T Kubokura, and K Tsubone, and T Sekino, and K Fujitsu
May 2009, Journal of hospital medicine,
Y Ishiwata, and H Fujino, and T Kubokura, and K Tsubone, and T Sekino, and K Fujitsu
January 1989, British journal of neurosurgery,
Y Ishiwata, and H Fujino, and T Kubokura, and K Tsubone, and T Sekino, and K Fujitsu
October 2019, Journal of neurological surgery reports,
Y Ishiwata, and H Fujino, and T Kubokura, and K Tsubone, and T Sekino, and K Fujitsu
August 1982, Neurosurgery,
Y Ishiwata, and H Fujino, and T Kubokura, and K Tsubone, and T Sekino, and K Fujitsu
April 2020, Operative neurosurgery (Hagerstown, Md.),
Copied contents to your clipboard!