Urgent decompression of tension pneumomediastinum in a patient to relieve elevated intracranial pressure: a case report

Khalid Mohamed Ahmed, Teresa V. Chan-Leveno, Bethany L. Lussier

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Timely recognition and intervention for venous outflow obstruction due to intrathoracic pathology are critical for controlling elevated intracranial pressure. Case Report: A 26-year-old man with pectus excavatum and a posterior fossa tumor requiring biopsy, decompression, and cerebrospinal fluid diversion developed pneumomediastinum following intubation with tension physiology and progressive elevation of intracranial pressure. Emergent tracheostomy was performed to decompress intrathoracic pressure, augment venous return, and ultimately expedite the patient’s definitive cancer therapy. Conclusion: Recognition of the mediastinal pathology leading to venous obstruction may be required for the management of malignant intracranial hypertension. Tracheostomy may be a means to decompress mediastinal pressure and augment venous outflow in rare cases of pneumomediastinum with tension physiology.

Original languageEnglish (US)
Pages (from-to)61-64
Number of pages4
JournalJournal of Neurocritical Care
Volume15
Issue number1
DOIs
StatePublished - Jun 2022

Keywords

  • Case report
  • Intracranial pressure
  • Mediastinal emphysema

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Advanced and Specialized Nursing

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