# Pneumocephalus and Seizure Post Cranioplasty: A Case Report

**Authors:** Tiago de Almeida Macruz, Gisele J Wakim, Livia Dahmen Rodrigues, Hudson Martins de Brito, Arthur V D Rezende

PMC · DOI: 10.7759/cureus.102003 · Cureus · 2026-01-21

## TL;DR

A 28-year-old man developed pneumocephalus and a seizure after cranioplasty, highlighting the need for close monitoring post-surgery.

## Contribution

This case report emphasizes the importance of monitoring for pneumocephalus complications during and after cranioplasty.

## Key findings

- The patient experienced delayed awakening and a seizure following cranioplasty.
- Imaging confirmed the presence of simple pneumocephalus.
- Close clinical monitoring is crucial for early detection of complications.

## Abstract

Pneumocephalus is a condition characterized by the presence of air within the intracranial space and can be classified as either simple or tension. It is associated with various etiologies, ranging from infectious causes to craniofacial surgical procedures such as cranioplasty. We report the case of a 28-year-old male patient with no previous comorbidities who after sustaining a gunshot wound to the head, underwent a cranioplasty for facial reconstruction under general anesthesia. During the immediate postoperative period, the patient exhibited delayed awakening followed by a seizure, requiring reintubation and intensive care support. Imaging studies revealed the presence of simple pneumocephalus. Although pneumocephalus is a known complication of cranioplasty surgeries, this case emphasizes the importance of continuous clinical monitoring by the healthcare team throughout the surgical period, including the anesthetic recovery, in order to enable the early identification and management of signs and symptoms associated with potential adverse outcomes.

## Full-text entities

- **Diseases:** neurosurgical emergencies (MESH:D004630), brain death (MESH:D001926), Seizure (MESH:D012640), neurological decline (MESH:D009461), headache (MESH:D006261), craniofacial trauma (MESH:D014947), cerebral artery (MESH:D002539), fractures (MESH:D050723), neoplasms (MESH:D009369), ocular deviation (MESH:D010262), meningitis (MESH:D008580), contusions (MESH:D003288), Pneumocephalus (MESH:D011007), non-obstructive hydrocephalus (MESH:D006849), herniation (MESH:D004677), neurological deterioration (MESH:D009422), brain tumor (MESH:D001932), epileptic seizures (MESH:D004827), died (MESH:D003643), brain injury (MESH:D001930), Hypertensive (MESH:D006973), neurological damage (MESH:D020196), decreased level of consciousness (MESH:D003244), subarachnoid hemorrhage (MESH:D013345), infections (MESH:D007239), ethmoiditis (MESH:D015521), dilation of the lateral ventricles (MESH:D002311), dilation of the third and fourth ventricles (MESH:C535966), hyperventilation (MESH:D006985)
- **Chemicals:** fentanyl (MESH:D005283), propofol (MESH:D015742), midazolam (MESH:D008874), flumazenil (MESH:D005442), PEEK (MESH:C063834), naloxone (MESH:D009270), nitrous oxide (MESH:D009609), levetiracetam (MESH:D000077287), convulsant medications (-), benzodiazepine (MESH:D001569), dexmedetomidine (MESH:D020927)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

20 references — full list in the complete paper: https://tomesphere.com/paper/PMC12923083/full.md

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Source: https://tomesphere.com/paper/PMC12923083