ORIGINAL ARTICLES  THORACIC SECTION 

The Journal of Cardiovascular Surgery 2007 June;48(3):385-7

Copyright © 2007 EDIZIONI MINERVA MEDICA

lingua: Inglese

Pneumocephalus after Pancoast’s tumor surgery: to be or not to be conservative?

Scanagatta P. ¹, Leo F. ¹, Veronesi G. ¹, Solli P. ¹, Gasparri R. ¹, Galetta D. ¹, Petrella F. ¹, Borri A. ¹, Spaggiari L. ^{1, 2}

¹ Thoracic Surgery Division European Institute of Oncology, Milan, Italy 2 School of Medicine University of Milan, Milan

We report a case of a 62-year-old man affected by Pancoast’s tumor who developed pneumocephalus 17 days after right upper lobectomy with en bloc resection of the first three ribs and C8-D1 branches of the brachial plexus. The patient complained of aphasia, disorientation and sphincterial release. A chest and brain-CT scan showed a right apical pneumothorax associated with a massive pneumocephalus of the ventricles and of the subarachnoidal spaces. A pneumoperitoneum was also seen. The patient was treated using pleural drainages, Trendelenburg’s position and antibiotic therapy. Clinical and radiological remission was achieved after 12 days of additional hospital stay.