Presentation
Headache, dizziness and left-sided hemiparesis. Status post clipping of left MCA aneurysm eight weeks ago.
Patient Data
Large pneumocephalus with typical Mount Fuji appearance indicative of tension pneumocephalus.
Case Discussion
This case depicts a postoperative pneumocephalus due to air entry following previous aneurysm clipping (see coronal and sagittal slices). The patient's symptoms are consistent with tension pneumocephalus. Tension pneumocephalus is a life-threatening condition needing urgent decompression by closure of the site of air entry. As seen in this CT brain, the presence of air compressing the tips of the frontal lobes, creates Mount Fuji sign, pathognomonic for tension pneumocephalus.