Tension pneumocephalus following bariatric surgery: case report.

Abstract

Bariatric surgery is an effective treatment for patients with idiopathic intracranial hypertension (IIH), a condition that is associated with skull base defects. A 55-year-old woman presented with symptoms of intractable nausea and vomiting, followed by headache and confusion two weeks after an elective laparoscopic vertical sleeve gastrectomy procedure. She had a presumed diagnosis of IIH and a remote history of CSF oto/rhinorrhea treated with a lumbar peritoneal (LP) shunt. Computed tomography (CT) scan of the head revealed tension pneumocephalus with midline shift and dehiscence of the tegmen. The patient underwent emergent craniotomy for decompression of the air-filled temporal lobe, clamping of the LP shunt, and repair of the skull base defect. Caution should be exercised in obese patients with a history of CSF leak secondary to a middle fossa skull base defect when being evaluated for bariatric surgery.

• Authors: Joseph H Marcotte, Ryan F Moncman, Marc J Branche, Todd L Siegal, Rohit A Patel, Alan R Turtz
• Journal: British journal of neurosurgery (Br J Neurosurg) Vol. 37 Issue 5 Pg. 1315-1318 (Oct 2023) ISSN: 1360-046X [Electronic] England
• PMID: 33393846 (Publication Type: Case Reports, Journal Article)

Topics

• Female
• Humans
• Middle Aged
• Pneumocephalus (diagnostic imaging, etiology, surgery)
• Cerebrospinal Fluid Rhinorrhea (etiology)
• Tomography, X-Ray Computed (adverse effects)
• Treatment Outcome
• Bariatric Surgery (adverse effects)
• Pseudotumor Cerebri