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Ann Thorac Surg 1995;59:234-236
© 1995 The Society of Thoracic Surgeons

Articles

Pneumocephalus complicating routine thoracotomy: Symptoms, diagnosis, and management

MD W. Morris Brown, III, MD Panagiotis N. Symbas*

Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA

Accepted for publication May 16, 1994.

* Address reprint requests to Dr Symbas, Department of Cardiothoracic Surgery, Emory University School of Medicine, 69 Butler St, SE, Atlanta, GA 30335.

Pneumocephalus resulting from a subarachnoid-pleural fistula most commonly occurs after trauma. Such a complication is very rarely seen after thoracotomy alone, with 15 cases reported to date in the literature. We report a case of pneumocephalus and subarachnoid-pleural fistula that developed secondary to thoracotomy. It was diagnosed by postmyelography computed tomography and treated with open surgical repair after a trial of conservative therapy failed. The presenting symptoms and signs, diagnostic methods, and options for therapy are reviewed.




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