pneumocephalus

some of our surgeons request that we use high flow oxygen for our pneumocephalic pt's as well. this is a controversial practice. there are a few studies out there, here's a link to the most recent:

http://thejns.org/doi/abs/10.3171/JN...ournalCode=jns

this study makes it sound like it works (and it very well may) but look at their population size. ;-)

This is peripheral to what you're discussing, but years ago, pneumoencephalograms were sometimes done: CSF was removed and oxygen introduced in order to provide contrast for x-rays. I remember that from school but never actually saw one done. They were pretty much abandoned when CT scans and MRIs were developed. I actually did a short Google search of the term to see if there was any information that addressed labman's question, but I didn't find anything.

I did take care of quite a few patients who had myelograms done, "back in the day" and know how bad the headache can be from losing just a small amount of CSF; I can't imagine how hideous a pneumoencephalogram must have been. We kept our myelogram patients flat and pushed fluids for 24 hours but occasionally one would think it was cute to "cheat" and sneak up to the bathroom; they very often lived to regret it.

it's not as rare as you think... i'd say that approx 50% of our crani for tumor pt's experience this post-op.

and this is coming from one of the top ranked neurosurg programs (sadly) lol

We diagnose this at least once an hour in our ER, and rarely use oxygen. The patients are usually happy with a couple of Percocet, and come back regularly.

we see it here and there, in fact, my pt. last week had quite a bit of air. 100% Fio2 x24hrs..blow it out..