Tension pneumocephalus after posterior fossa craniotomy, a complication of the sitting position

Abstract

The sitting position provides optimal operating conditions for surgical procedures on the cervical spinal column, posterior fossa, and gasserian ganglion, but is associated with some potential complications. The risks of air embolism and postural hypotension have been well recognized. More recently, several instances of position related venous obstruction and consequent edema of the tongue or head and neck have been reported. To the authors' knowledge, tension pneumocephalus resulting from the sitting position during posterior fossa craniotomy has not been previously described. A case of a 66 year old man is described.