第38回日本小児神経外科学会
The 38th Annual Meeting of the Japanese Society for Pediatric Neurosurgery

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第1日目、6月4日(金)A 会場(3階 メインホール)9:40〜10:40

特別企画 1: JSPN - KSPN joint session: 3. Case discussion

Chairperson: Kyu-Chang Wang, Takayuki Inagaki

SP1-3-2

Spontaneous pneumocephalus in a patient with longstanding brain tumor and ventriculoperitoneal shunt

Il-Woo Lee, Jiho Yang, Jin-Seok Yi, Hyung-Jin Lee, In-Seong Yeo

Department of Neurosurgery, Daejon St. Mary s Hospital, Catholic University of Korea

A 18 years old boy was admitted because of severe headache. He has been diagnosed as pilocytic astrocytoma by stereotaxic biopsy 10 years ago and treated conservatively. He developed hydrocephalus 5 years ago and received ventriculo-peritoneal shunt. He was relatively stable and treated with anticonvulsant at the outpatient clinic except blindness and mild left side hemiparesis that were developed 8 years ago.
The CT scanning was performed and multiple scattered air shadows was found at the basal cistern and arachnoid spaces of both hemisphere. CT and MRI with intrathecal contrast medium injection could not reveal any air or CSF leaking point but small bony fracture site was found at the frontal skull base.
Trans-nasal endoscopic operation was performed and small bony defect with dural tear was found at the lamina cribrosa. Defected area was closed with artificial dura and medpore. After operation, headache was disappeared and no more pneumocephlaus was developed at the follow up check. The pathophysioloy of spontaneous pneumocephalus was discussed.

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