Tension Pneumocranium: The Largest Case Seriies

Abstract

We describe series of cases of symptomatic tension pneumocranium, a rare, potentially life-threatening complication of intracranial surgery. The Mount Fuji sign is a characteristic finding that can be observed on computed tomographic (CT) scans of the brain, in which bilateral subdural hypoattenuating collections cause compression and separation of the frontal lobes. The collapsed frontal lobes and the widening of the interhemispheric space between the tips of the frontal lobes have the appearance of the silhouette of Mount Fuji —hence, the Mount Fuji sign.

In cases of suspected pneumocranium, CT can play a vital role in determining the precise and definite location of the gas collection and the amount of mass effect on the brain which may need urgent recognition and intensive observation with decompression to minimize pressure over the brain parenchyma.

To our best knowledge this is the largest case series being reported to date.