PNEUMOCEPHALUS AFTER THORACOTOMY

BACKGROUND Pneumocephalus is a well-known phenomenon in which a fistul a between the thoracic cavity and the subarachnoid space is one of its rare etiologies. METHODS We report a new case of pneumocephalus after thoracotomy and review eight similar cases in the literature. RESULTS In all cases, an operation was carried out for an intrathoracic neopl asm located at the apex with chest wall invasion. In the presence of s ymptoms, the diagnosis of pneumocephalus and identification of the sub arachnoid pleural fistula were differently supplied by radiographic an d isotopic exams. In the follow-up, one patient was affected by mening itis and two patients died. CONCLUSIONS The occurrence of pneumocephal us must be considered when neurologic problems emerge after thoracotom y. It appears that if conservative treatment fails, surgical closure o f the fistula via thoracic or neurosurgical approach is indicated.