After cranial surgery air or gas may collect within the cranium (pneumocephalus) and can cause symptoms during postoperative recovery.
Risk factors for pneumocephalus:
(1) posterior fossa craniotomy
(2) patient in a head-up posture
(3) use of nitrous oxide (N2O) after sealing of the intracranial space during cranial closure
Clinical findings:
(1) increasing "tightness" to the brain during the surgery
(2) delayed awakening, nonwaking or impaired consciousness after surgery
(3) severe headache after surgery
The diagnosis can be confirmed by taking a lateral skull X-ray or cranial CT scan with the brow up.
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Specialty: Anesthesiology, Neurology, Surgery, orthopedic
