Pneumocephalus complicating routine thoracotomy: symptoms, diagnosis and management.

Pneumocephalus resulting from a subarachnoid-pleural fistula most commonly occurs after trauma. Such a complication is very rarely seen after thoracotomy alone, with 15 cases reported to date in the literature. We report a case of pneumocephalus and subarachnoid-pleural fistula that developed secondary to thoracotomy. It was diagnosed by postmyelography computed tomography and treated with open surgical repair after a trial of conservative therapy failed. The presenting symptoms and signs, diagnostic methods, and options for therapy are reviewed.