PNEUMOCEPHALUS (grech, pneuma air + kephale head; synonym: pneumocrania, pneumocele, pneumocysta cerebri, pneumocephalus) — penetration of air into a head cavity.
Depending on the place of accumulation of air distinguish P. ekstratserebralny (accumulation of air out of a brain — epiduralno, subduralno, subarakhnoidalno), intratserebralny (accumulation of air in substance of a brain), intraventricular (accumulation of air in cerebral cavities) or mixed.
The etiology and a pathogeny
is most often observed by P. at injuries of the head (fire and not fire damages), however can arise also at the tumoral processes leading to development of the message between a head cavity and external environment. P.'s development is usually connected with a fracture of the bones making walls of okolonosovy bosoms (frontal, the main, trellised). Changes of this localization radiological come to light far pe always. The item can sometimes develop also without disturbance of an integrity of bones of a skull, napr, at the closed brain injuries when owing to increase in intracranial pressure the firm meninx is strongly stuck out in openings of a sievebone and is broken off. Through these gaps air gets into a head cavity. The item always confirms the getting injury of a skull and danger an infitsirovapiya of a brain. It dictates need of acceptance of the appropriate preventive measures.
A clinical picture
At P. patients complain of feeling of transfusion of liquid, a crash, gurgle in the head, especially at its turns. The item can develop as peposredstvepno after an injury, and in several days or even weeks after it. Especially hard valve P. proceeds, at a cut air is sucked in in a head cavity during a breath, tension (a smorkaniye, defecation etc.), causing continuous increase intracranial pressure (see), prelum of a brain (see) and that is especially dangerous, its trunk. Sometimes at valve P, air can accumulate also under soft tissues of the person, breast, leading to emergence of hypodermic emphysema (see. Emphysema ).
The diagnosis is made on the basis of the anamnesis and characteristic by a wedge, pictures. The final diagnosis is established later kraniografiya (see), at a cut come to light accumulation of air in a head cavity and, more rare, bone cracks (fig).
Treatment and the Forecast
Uncomplicated P. usually recovers under the influence of conservative actions (rest, an exception of exercise stresses, tension, preventive antibacterial therapy). At open injuries of a skull careful surgical treatment of wounds is shown. Valve P. with the phenomena of a compression of a brain demands the emergency operative measure for the purpose of detection and elimination of the valve. At P. lumbar punctures should be carried out with care since at bystry cerebral decompression conditions for suction in a head cavity of air with the subsequent accruing compression of a brain can be created.
The forecast depends hl. obr. from the reason which called P. Inogd the accumulated air resolves independently. At valve P. the forecast serious.
Bibliography: Kopylov M. B. Bases of radiodiagnosis of diseases of a brain, M., 1968; The Guide to neurotraumatology, under the editorship of A. I. Arutyunov, p.1, page 177, 367, M., 1978.
V. V. Lebedev.