Özgür DEMİR, Nejmi KIYMAZ, Nebi YILMAZ

Posttraumatic delayed tension pneumocephalus: Case report

Amaç: Tansiyon pnömosefali ani intrakranial basınç artışına neden olduğu için acil müdahale gerektiren bir patolojidir. Bu çalışmada, posttravmatik geç dönemde oluşan ve hastanın hayatını tehdit eden bir tansiyon pnömosefali olgusunun sunulması amaçlandı. Olgu: Trafik kazası nedeniyle acil polikliniğimize başvuran, giriş nörolojik muayenesi normal fakat şiddetli baş ağrısı olan 63 yaşında bir erkek hastaya yapılan BBT'de frontal sinüs fraktürü, frontal kontüzyonel kanama ve minimal pnömosefali tespit edildi. Kliniğe yatırılıp takip edilen hastanın 11. gün şuur düzeyinde gerileme olması nedeniyle yapılan BBT'de, subdural, intraventriküler ve intraparankimal basınçlı hava tespit edildi.Hava beyin dokusuna arka fossa dahil tüm intrakraniyal alanda ileri derecede bası yapıyordu. Hasta acil olarak ameliyat edilerek basınçlı hava boşaltıldı. Postoperatif hastanın şuur düzeyi açıldı. Sonuç: Tansiyon pnömosefali, genellikle erken dönem oluşmakla beraber, posttravmatik geç dönemlerde de ortaya çıkabilir. Bu nedenle basit pnömosefali bulunan hastaların uzun dönem yakın takipleri faydalıdır.

Posttravmatik gecikmiş tansiyon pnömosefali: Olgu sunumu

Aim: Tension pneumocephalus is a problem that requires emergent intervention for the fact that it can lead to sudden increase in intracranial pressure. In this study we present a case of late tension pneumocephaly which threatened the life of the patient. Subject: A 63-year-old man was admitted to our emergency unit with severe headache after being involved in a traffic accident. Radiological exams showed frontal sinus fracture, frontal cerebral contusion and minimal pneumocephalus. Conservative treatment was initiated. On the eleventh day he had a disturbance in consiousness, hence another cranial computerized tomography was taken which revealed subdural, intraventricular and intraparenchymal tense air that caused high pressure on the brain and intracranial areas including the posterior fossa. The patient was operated on urgently and the tense air was evacuated. During the postoperative period the patient’s state of conscious began to improve. Result: In view of this situation, although tension pneumocephaly generally develops during the early posttraumatic period, it should be kept in mind that it can also develop in the late phase. So long-term, close observation for the patients with simple pneumocephaly is beneficial.

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