Pneumocephalus after Thoracoscopic Excision of Posterior Mediastinal Mass -A case report-

흉강경적 후종격동 종양 절제 후 발생한 뇌공기증 - 1예 보고 -

  • Lee, Hyang-Lim (Department of Cardiothoracic Surgery, Gil Medical Center, Gachon University of Medicine and Science) ;
  • Park, Kook-Yang (Department of Cardiothoracic Surgery, Gil Medical Center, Gachon University of Medicine and Science) ;
  • Park, Chul-Hyun (Department of Cardiothoracic Surgery, Gil Medical Center, Gachon University of Medicine and Science) ;
  • Jeon, Yang-Bin (Department of Cardiothoracic Surgery, Gil Medical Center, Gachon University of Medicine and Science) ;
  • Choi, Chang-Hyu (Department of Cardiothoracic Surgery, Gil Medical Center, Gachon University of Medicine and Science) ;
  • Lee, Jae-Ik (Department of Cardiothoracic Surgery, Gil Medical Center, Gachon University of Medicine and Science)
  • 이향림 (가천의과학대학교 길병원 흉부외과학교실) ;
  • 박국양 (가천의과학대학교 길병원 흉부외과학교실) ;
  • 박철현 (가천의과학대학교 길병원 흉부외과학교실) ;
  • 전양빈 (가천의과학대학교 길병원 흉부외과학교실) ;
  • 최창휴 (가천의과학대학교 길병원 흉부외과학교실) ;
  • 이재익 (가천의과학대학교 길병원 흉부외과학교실)
  • Published : 2007.12.05

Abstract

Pneumocephalus after thoracoscopic excision of a mediastinal mass is a very rare complication. It presumably occurs due to dural injury near the spinal root and development of a subsequent subarachnoid-pleural fistula. A 60-year-old woman complained of nausea and headache after thoracoscopic excision of a posterior mediastinal mass. She was diagnosed with pneumocephalus by brain CT and recovered with supportive management.

흉강경적 종격동 종양 절제 후 발생하는 뇌공기증은 매우 드문 합병증으로, 척수근 주위 경막의 손상으로 인해 발생한 거미막하강-흉강 누공이 그 원인이다. 후종격동 종양으로 흉강경적 종양 절제술을 시행 받은 60세 환자가 수술 직후부터 지속적인 오심과 두통을 호소하여 시행한 뇌 전산화 단층 촬영에서 뇌공기증이 진단되었고, 보존적 치료로 호전되었기에 이를 보고하는 바이다.

Keywords

References

  1. Black PM, Davis JM, Kjellberg RN, Davis KR. Tension pneumocephalus of the cranial subdural space. Neurosurgery 1979;5:368-70 https://doi.org/10.1227/00006123-197909000-00012
  2. Luo CB, Teng MM, Chen SS, Liring JF, Chang FC. Pneumocephalus secondary to septic thrombosis of the superior sagittal sinus: report of a case. J Formos Med Assoc 2001;2:142-4
  3. Kuo MY, Lien WC, Wang HP, Chen WJ. Nontraumatic tension pneumocephalus-a differential diagnosis of headache at the ED. Am J Emerg Med 2005;23:235-6 https://doi.org/10.1016/j.ajem.2004.02.044
  4. D'Addario R, Greeberg J, O'Neill THE, Spagna P. Pneumocephalus: an unusual case. J Neurol Neurosurg Psychiatry 1974;37:271-4 https://doi.org/10.1136/jnnp.37.3.271
  5. Brown WM, Symbas PN. Pneumocephalus complicating routine thoracotomy: symptoms, diagnosis, and management. Ann Thorac Surg 1995;59:234-6 https://doi.org/10.1016/0003-4975(94)00434-9
  6. Huang YK, Lu MS, Liu YH, Wu YC, Liu H. Pneumocephalus after thoracoscopic excision of posterior mediastinal tumor. J Formos Med Assoc 2005;104:848-51
  7. Reddy HVR, Queen S, Prakash D, Jilaihawi ANA. Tension pneumocephalus: an unusual complication after lung resection. Eur J Cardiothorac Surg 2003;24:171-3 https://doi.org/10.1016/S1010-7940(03)00191-X