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  • Title: [Massive pneumocephalus and cerebrospinal fluid fistula after thoracotomy].
    Author: Olarra J, Longarela A.
    Journal: Rev Esp Anestesiol Reanim; 2008 Oct; 55(8):504-7. PubMed ID: 18982788.
    Abstract:
    We report the case of a 70-year-old man (ASA physical status 2) who developed massive pneumocephalus caused by a fistula between the subarachnoid and pleural spaces following a left pneumonectomy. After an uneventful immediate postoperative period, the patient was readmitted to the recovery care unit with dyspnea, intense headache, confusion, and diminished level of consciousness. Computed tomography confirmed a cerebrospinal fluid fistula secondary to the opening of the intradural space during tumor resection. Treatment was conservative, consisting of rest in a slightly Trendelenburg position, antibiotic prophylaxis to prevent meningitis, and a water seal on the thoracic drainage tube.
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