Summary of tension pneumocephalus cases after surgical evacuation of CSDH in the literature
| Authors | Year | Number of CSDH cases | Number of cases with tension pneumocephalus | Age | Clinical presentation | Days after primary surgery | Drain | Management | Outcome |
|---|---|---|---|---|---|---|---|---|---|
| Bouzarth et al. [22] | 1980 | 5 | 5 | 59–80 | Impaired consciousness | 3 days | Subdural | Case 1: craniotomy; case 2: subdural aspiration; case 3: catheter removal; case 4: subcutaneous aspiration; case 5: subdural suction | All cases improved |
| Monajati and Cotanch [14] | 1982 | 6 | 1 | 86 | Right arm weakness and speech difficulty | 2 days | Subdural | Subdural tap | Weakness improved |
| Bremer and Nguyen [10] | 1982 | 19 | 3 | 60–80 | Agitation and impaired consciousness | 2 days | N/M | Case 1: emergency craniotomy; case 2: emergent catheter aspiration; case 3: suctioning | Case 1: no improvement; case 2: improved; case 3: improved |
| Caron et al. [24] | 1985 | N/M | 1 | 74 | Impaired consciousness | N/M | Subdural | Burr hole drainage of the air and lumbar catheter Elliott solution infusion | Improved |
| Kawakami et al. [25] | 1985 | N/M | 1 | N/M | N/M | N/M | N/M | Closed system drain | Improved |
| Atluru and Kumar [26] | 1987 | N/M | 1 | 10 weeks | Macrocephaly, diffuse hypertonia, and hyperreflexia with marked head lag | 1 day | N/M | Needle aspiration | Improved |
| Ishiwata et al. [11] | 1988 | 196 | 5 | 70–86 | Impaired consciousness | 6 h–2 days | N/M | Burr hole evacuation | All cases improved |
| Sharma et al. [4] | 1989 | 63 | 5 | 6–60 | Drowsiness and impaired consciousness | 5–24 h | N/M | Drill craniostomy and aspiration | All cases improved |
| Lavano et al. [23] | 1990 | 7 | 7 | 40–85 | Impaired consciousness | N/M | N/M | Case 1: aspiration of the air, spinal saline infusion; case 2: craniotomy; case 3: burr hole with catheter aspiration; case 4: craniotomy with removal of the air and a membrane; case 5: craniotomy with removal of the air and a membrane; case 6: burr hole evacuation; case 7: burr hole evacuation no improved than craniotomy | All cases improved except case 7 died due to pneumonia |
| Merlicco et al. [27] | 1995 | 70 | 5 | > 70 | Impaired consciousness | 12 days | N/M | N/M | Three cases died, one due to a medical cause; the other 2 cases improved |
| Mori and Maeda [28] | 2001 | 500 | 4 | N/M | Impaired consciousness | N/M | Subdural | Reopening the wound and burr hole evacuation | All cases improved |
| Cummins [29] | 2009 | N/M | 1 | 78 | Impaired consciousness | N/M | Subdural | Catheter aspiration | Improved |
| Shaikh et al. [20] | 2010 | N/M | 1 | 70 | Impaired consciousness | 3 days | Subdural | Aspiration and catheter insertion | Improved |
| Ihab [30] | 2012 | 50 | 2 | 60 and 62 | Case 1: impaired consciousness; case 2: headache | N/M | N/M | Conservative case 1: simple aspiration; case 2: nursing in a flat position, administration of fluids, and supplemental breathing of 100% O2 | Both cases improved |
| Mehesry et al. [31] | 2016 | N/M | 1 | 68 | Increased right arm weakness and expressive aphasia | N/M | Subdural | Conservative management | Improved |
| Balevi [32] | 2017 | 148 | 8 | N/M | N/M | N/M | Subdural | Closed subdural drainage | All cases improved |
| Turgut and Yay [33] | 2019 | N/M | 1 | 59 | Seizures | 3 days | Subcutaneous | Burr hole evacuation | Improved |
| Moscovici et al. [34] | 2019 | 45 | N/M | > 90 | N/M | N/M | N/M | Conservative management | N/M |
| Dobran et al. [35] | 2020 | 153 | 2 | N/M | N/M | N/M | N/M | Burr hole evacuation | All cases improved |
| Celi and Saal [36] | 2020 | N/M | 1 | 85 | Rapid neurological deterioration | 2 days | Subdural | Conservative management | Death |
| Lepić et al. [37] | 2022 | N/M | 1 | 81 | Hypertension | N/M | Subdural | Emergency irrigation | No improvement and no further surgery was needed |
O2: oxygen; N/M: not mentioned