The Incidence of Pneumocephalus after Cerebral Aneurysm Surgery

Eun Ju Paik, Jong In Han, Rack Kyung Chung, Guie Yong Lee, Chi Hyo Kim, Jong Hak Kim, Choon Hi Lee, Hae Young Choi*

Copyright ⓒ 1997. Ewha Womans University School of Medicine. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published Online: Jul 24, 2015

Abstract

Objectives

Pneumocephalus is a pathologic collection of gas within the cranial cavity. Patients undergoing neurosurgical procedures may be at increased risk for the development of tension paneumocephalus if nitrous oxide(N₂O) is used during a subsequent anesthetic.

Methods

Thirty-seven patients undergoing cerebral aneurysm surgery had a computed tomographic scan of the head performed on or after the day of their surgery. 64 scans were examined for the presence of intracranial air. The magnitude of pneumocephalus was recorded as A-P(mm), width(m),& numbers of section.

Results

Air was seen in all scans obtained in the first three postoperative days, During the second postoperative weeks, the incidence and the size of pneumocephalus decreased. A significant number of patients have an intracranial air collection in the first two weeks after the procedure.

Conclusion

These data indicate that all patients have pneumocephalus immediately after a cerebral aneurysm surgery. This information should be considered in the evaluation of the patient and the selection of anesthetic agents during a second anesthetic in the first 2 weeks after the first procedure.

Keywords: Pneumocephalus; Nitrous oxide