Pneumocephalus After Mediastinal Surgery

Abstract

Figures

A](#f1-squmj2854)]. Magnetic resonance imaging (MRI) revealed a right apico-posterior mediastinal mass, which was excised via uniportal video-assisted thoracoscopic surgery (VATS) [[Fig. 1B](#f1-squmj2854) & [Fig. 1C](#f1-squmj2854)]. Histopathological analysis confirmed a diagnosis of schwannoma. Seventy-two hours after surgery, she developed a mild headache but exhibited no other neurological signs. An urgent computed tomography scan of the brain confirmed the presence of pneumocephalus [[Fig. 1D](#f1-squmj2854)]. Her symptoms resolved within 48 hours with bed rest and oxygen therapy. She wa

Full text

A 63-year-old female patient underwent investigation at a teaching hospital in Rabat, Morroco, in November 2023 for an incidental right apical opacity detected on a chest radiograph [Fig. 1A]. Magnetic resonance imaging (MRI) revealed a right apico-posterior mediastinal mass, which was excised via uniportal video-assisted thoracoscopic surgery (VATS) [Fig. 1B & Fig. 1C]. Histopathological analysis confirmed a diagnosis of schwannoma. Seventy-two hours after surgery, she developed a mild headache but exhibited no other neurological signs. An urgent computed tomography scan of the brain confirmed the presence of pneumocephalus [Fig. 1D]. Her symptoms resolved within 48 hours with bed rest and oxygen therapy. She was discharged without symptoms on the 10^th^ postoperative day.

1. Comments

Mediastinal schwannomas are benign neurogenic neoplasms with an excellent prognosis following surgical excision.^1^ VATS is a safe and effective approach for the resection of thoracic neurogenic tumours, except for dumbbell-shaped tumours.^2^ In our clinical practice, MRI serves as a cornerstone diagnostic modality for assessing the spatial relationship between the tumour and adjacent neurovascular structures, facilitating optimal surgical planning.^3^

Pneumocephalus may rarely occur as a postoperative complication. While often self-limiting and asymptomatic, conservative management is typically the preferred course of action. This approach should be complemented by vigilant clinical monitoring and appropriate follow-up to ensure complete resolution.^34^

Authors' Contribution

Mohamed Bhairis: Conceptualization, Writing - Original Draft. Massine El Hammoumi: Formal Analysis. El Hassane Kabiri: Writing - Original Draft, Writing - Review & Editing.

Ethics Statement

Written informed consent was obtained from the patient for publication of this case.