J-F Mineo1, D H Phong, R Seizeur, Ph Mériot, G Besson. 1. Department of Neurosurgery, La Cavale Blanche Hospital, University of Bretagne Occidental, boulevard Tanguy-Prigent, 29200 Brest. jfmineo@hotmail.com
Abstract
OBJECTIVE AND IMPORTANCE: Delayed and isolated tension intraventricular pneumocephalus without air in the pericerebral subarachnoid spaces is an exceptional complication of a ventriculoperitoneal (VP) shunt. We purpose an explanation for the development of such delayed pneumocephalus. CLINICAL PRESENTATION: A 14-year-old boy developed headaches and right-side hearing loss three months after surgical resection of a cerebellar medulloblastoma and insertion of a VP shunt. CT-scan showed isolated intraventricular pneumocephalus without air in the pericerebral subarachnoid spaces. A petrous bone defect was discovered and surgically repaired with clinical and radiographic resolution of pneumocephalus. CONCLUSION: We presume that the brain tIssue plugging the bony defect retracted following the placement of the shunt and eventually there was rupture through the pia-mater into the lateral ventricle. This could explain why isolated intraventricular occurred, as opposed to air in the subarachnoid spaces.
OBJECTIVE AND IMPORTANCE: Delayed and isolated tension intraventricular pneumocephalus without air in the pericerebral subarachnoid spaces is an exceptional complication of a ventriculoperitoneal (VP) shunt. We purpose an explanation for the development of such delayed pneumocephalus. CLINICAL PRESENTATION: A 14-year-old boy developed headaches and right-side hearing loss three months after surgical resection of a cerebellar medulloblastoma and insertion of a VP shunt. CT-scan showed isolated intraventricular pneumocephalus without air in the pericerebral subarachnoid spaces. A petrous bone defect was discovered and surgically repaired with clinical and radiographic resolution of pneumocephalus. CONCLUSION: We presume that the brain tIssue plugging the bony defect retracted following the placement of the shunt and eventually there was rupture through the pia-mater into the lateral ventricle. This could explain why isolated intraventricular occurred, as opposed to air in the subarachnoid spaces.
Authors: Mariangela B Gonçalves; Cristian F Nunes; José O Melo; Rodrigo D Guimarães; João Klescoski; José A Landeiro Journal: Surg Neurol Int Date: 2012-10-13