Pneumocephalus after spinal surgery

Case contributed by Bruno Di Muzio
Diagnosis probable

Presentation

Headaches. On the third postoperative day after lumbar spinal fusion surgery.

Patient Data

Age: 46-year-old
Gender: Male

CT Brain

ct

Appearance and density of the brain parenchyma are normal. Ventricular system and cisternal spaces appear normal. No evidence of intracranial space occupying lesion is detected. There is no shift of the midline structures. Two small extra-axial pneumocephalus bubbles are present adjacent to the right frontal lobe. The visualized orbits, paranasal sinuses and calvarium appear unremarkable.

Case Discussion

It is hard to correlate a headache unequivocally to those tiny pneumocephalus bubbles. This case is important to underline that this condition can be found after not only cranial surgeries but also after spinal manipulations such as lumbar puncture or surgery. 

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