Abstract
A 72-year-old male had endoscopic sinus surgery (ESS) at an outside hospital for chronic sinusitis with extensive nasal polyposis. This was complicated by an intraoperative cerebrospinal fluid (CSF leak) that was recognized at the time of surgery in addition to a transgression of the lamina papyracea. A left ethmoid cribriform defect was noted and an attempt at intraoperative repair was performed with dural matrix and fibrin sealant in addition to lumbar drain placement by Neurosurgery. Postoperatively, the patient noted horizontal diplopia as well as intermittent but persistent unilateral clear drainage. On the evening of postoperative day 2, the patient developed increased drowsiness and altered mental status. Computed tomography (CT) imaging of the brain and sinuses on postoperative day 2 demonstrated increased pneumocephalus (Fig. 12.1). High-flow oxygen delivery was started through a Venturi mask, the lumbar drain was clamped, and the patient transferred to a tertiary care hospital.
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Falls, M., Ting, J. (2022). Tension Pneumocephalus. In: Chandra, R.K., Welch, K.C. (eds) Lessons Learned from Rhinologic Procedure Complications. Springer, Cham. https://doi.org/10.1007/978-3-030-75323-8_12
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