Eccentric topic of the Week, Neuroradiology
Question 20:
The correct answer is A, administrator of 100% oxygen.
A burr hole might be necessary, but there should be no delay in initiation of 100% oxygenation.
When the clinical and imaging findings are correctly identified, treatment consists of emergent decompression to alleviate pressure on the brain parenchyma. Treatment options for tension pneumocephalus including drilling of burr holes, craniotomy, needle aspiration, ventriculostomy placement, administration of 100% oxygen, and closure of dural defects. Careful monitoring for clinical signs of deterioration as well as serial CT scanning of the brain, is recommended. In patients who are treated for tension pneumocephalus, resolution of the subdural air collection is expected.
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