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CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2022; 09(03): 204-206
DOI: 10.1055/s-0042-1751091
Case Report

Posttraumatic Tension Pneumocephalus Causing Atropine-Resistant Bradycardia

Yagna M. Gali
1   Department of Neuroanaesthesiology and Neuro Critical Care, Apollo Hospitals, Jubilee Hills, Hyderabad, Telangana, India
,
Lakshman K. Kommula
1   Department of Neuroanaesthesiology and Neuro Critical Care, Apollo Hospitals, Jubilee Hills, Hyderabad, Telangana, India
,
Subba R. Kesavarapu
2   Department of Critical Care Medicine, Apollo Hospitals, Jubilee Hills, Hyderabad, Telangana, India
,
Shekhar R. Gurrala
3   Department of Neuroanaesthesiology and Neuro Critical Care, Apollo Hospitals, Hyderabad, Telangana, India
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Abstract

Pneumocephalus is a serious complication following brain trauma. Tension pneumocephalus (TP) is entrapment of a large volume of air in the cranial vault causing mass effect on the brain parenchyma. It is the intracranial counterpart of tension pneumothorax and if neglected, can be life threatening. TP should be timely differentiated from benign pneumocephalus owing to its various nonspecific and lethal complications. Our patient is a 37-year-old male with a history of road traffic accident who presented to our hospital with headache and nasal discharge for the last two days. Computed tomography showed multiple skull fractures and extensive pneumocephalus. His preoperative heart rate was 38 beats per minute that was resistant to pharmacological interventions and required a temporary pacemaker for surgery. He underwent uneventful craniotomy for dura repair and was discharged home with no neurological deficit.

Keywords

bradycardia - pacemaker - pneumocephalus


Publication History

Article published online:
17 December 2022

© 2022. Indian Society of Neuroanaesthesiology and Critical Care. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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