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Tension pneumocephalus mimicking septic shock: a case report.

TitleTension pneumocephalus mimicking septic shock: a case report.
Publication TypeJournal Article
Year of Publication2018
AuthorsMiranda C, Mahta A, Wheeler LAdam, A Tsiouris J, Kamel H
JournalRadiol Case Rep
Volume13
Issue1
Pagination241-243
Date Published2018 Feb
ISSN1930-0433
Abstract

Tension pneumocephalus can lead to rapid neurologic deterioration. We report for the first time its association with aseptic systemic inflammatory response syndrome mimicking septic shock and the efficacy of prompt neurosurgical intervention and critical care support in treating this condition. A 64-year-old man underwent 2-stage olfactory groove meningioma resection. The patient developed altered mental status and gait instability on postoperative day 6. Imaging showed significant pneumocephalus. The patient subsequently developed worsening mental status, respiratory failure, and profound shock requiring multiple vasopressors. Bedside needle decompression, identification and repair of the cranial fossa defect, and critical care support led to improved mental status and reversal of shock and multiorgan dysfunction. Thorough evaluation revealed no evidence of an underlying infection. In this case, tension pneumocephalus incited an aseptic systemic inflammatory response syndrome mimicking septic shock. Prompt neurosurgical correction of pneumocephalus and critical care support not only improved neurologic status, but also reversed shock. Such a complication indicates the importance of close monitoring of patients with progressive pneumocephalus.

DOI10.1016/j.radcr.2017.10.008
Alternate JournalRadiol Case Rep
PubMed ID29487661
PubMed Central IDPMC5826457

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