Tension pneumocephalus

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Deteriorating consciousness in a patient with a recent history of chronic subdural haematoma evacuation.

Patient Data

Age: 70 years
Gender: Male
ct

Bilateral subdural air causing compression and separation of the frontal lobes creating a characteristic appearance termed the "Mount Fuji sign" indicating tension pneumocephalus with air bubbles within the hypodense subdural fluid collection.

Two parietal burr holes are noted on 3D-VR.

Case Discussion

CT features of tension pneumocephalus post evacuation of bilateral subdural haematomas.

Tension pneumocephalus is considered a neurosurgical emergency that occurs when subdural air causes an extra-axial mass effect with compression of the frontal lobes.

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