Extensive tension pneumocephalus complicating continuous lumbar CSF drainage for the management of CSF rhinorrhoea.

We report a case of tension pneumocephalus developing after a continuous lumbar CSF drain had been inserted for the treatment of CSF rhinorrhoea following translabyrinthine removal of a vestibular schwannoma. Despite conservative management, the patient developed recurrent CSF rhinorrhoea and hydrocephalus requiring explorations of the petromastoid cavity, an external ventricular drain and eventually a lumbar-peritoneal shunt. The prevention and management of pneumocephalus secondary to continuous lumbar CSF drainage is briefly reviewed. Copyright 2003 S. Karger AG, Basel