Esophageal-subarachnoid fistula: a case of spontaneous tension pneumocephalus in the setting of esophageal cancer.

Head & Neck Pub Date : 2014-06-01 Epub Date: 2014-03-25 DOI:10.1002/hed.23459
Mihir R Patel, Winslo Idicula, Ricardo L Carrau, Daniel M Prevedello
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引用次数: 2

Abstract

Background: Pneumocephalus occurs as a result of traumatic or iatrogenic violation of the dura. Tension pneumocephalus, whereby air continues to accumulate with no mechanism for escape, can cause significant morbidity and mortality.

Methods: This case report reviews the underlying pathophysiology, clinical presentation, diagnosis, and management of tension pneumocephalus.

Results: We present the case of a 68-year-old man who presented to the Emergency Department with headache thought to be the result of a newfound intracranial mass. After admission, he became obtunded and was found to have tension pneumocephalus requiring emergent evacuation. A cervical esophagus carcinoma caused an esophageal-subarachnoid fistula that resulted in tension pneumocephalus after a retching episode.

Conclusion: This case illustrates the importance of considering alternative sources of pneumocephalus in the absence of more typical differential diagnosis.

食管癌并发自发性张力性脑积水1例。
背景:脑气是外伤性或医源性硬脑膜侵犯的结果。张力性气颅,即空气持续积聚而无逃逸机制,可引起显著的发病率和死亡率。方法:本病例报告回顾了紧张性脑气的病理生理、临床表现、诊断和治疗。结果:我们提出的情况下,68岁的男子谁提出了头痛的急诊科认为是新发现的颅内肿块的结果。入院后,他变得昏厥,被发现有紧张性脑气,需要紧急疏散。宫颈食管癌引起食管-蛛网膜下腔瘘,在干呕吐后导致张力性脑气。结论:这个病例说明了在没有更典型的鉴别诊断的情况下,考虑其他气头来源的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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