Tension Pneumocephalus After Right Dacryocystorhinostomy: A Rare but Potential Serious Complication

Abstract

Tension pneumocephalus is a phenomenon in which air enters through dural injury in the brain and then expands and causes a mass effect. The injury can be due to any neurosurgical procedure, trauma, infection and/or neoplasm. A 63-year-old female known case of diabetes and hypertension had an elective procedure of right dacryocystorhinostomy present to the emergency department the very next day with a loss of consciousness. Urgent CT of the head showed air in the cranium (pneumocephalus). A radiological sign named "Mount Fuji" is classical for tension pneumocephalus. She was closely monitored and shows good clinical improvement allowing the neurosurgery team to avoid any intervention. The rationale to present this case is that to our knowledge, this is the first case in which tension pneumocephalus had occurred post-dacryocystorhinostomy. Due to the delicate region operated during eye surgeries, one should be more careful and vigilant.