Symptomatic spontaneous pneumocephalus after spinal fusion for spondylolisthesis.

Symptomatic spontaneous pneumocephalus after a spinal fusion for spondylolisthesis without injury to the dura mater is rare. There are only a few reports of tension pneumocephalus after spinal operations published in English. We present a patient who developed tension pneumocephalus without recognised dural injury during surgery. CT cisternography and MRI showed no anatomical defects that could have caused the pneumocephalus. We suggest that spontaneous pneumocephalus without dural injury may occur after a spondylolisthesis operation because of increased intra-abdominal pressure, and thus may be avoided by the careful management of abdominal pressure.