Delayed Tension Pneumocephalus Following Intraoperative Cerebrospinal Fluid Leakage Repair

Abstract

Tension pneumocephalus is a rare complication of endoscopic sinus surgery (ESS) that may lead to rapid neurologic deterioration. Symptoms typically develop within the first postoperative week after enough air has entered the intracranial cavity to create pressure on the dura. Furthermore, there may be a rapid onset of symptoms after a positive pressure event. However, there may be a more insidious onset of symptoms in the absence of a positive pressure event. We report a rare case of delayed tension pneumocephalus following an intraoperative cerebrospinal fluid leak repair. We discuss here the mechanisms of this complication and the diagnosis and treatment strategies of tension pneumocephalus after an ESS.