Tension Pneumocephalus after Endoscopic Paranasal Sinus Surgery

Tension pneumocephalus (TP) which produces increased intracranial pressure and leads to neurological deterioration is a rare but life-threatening complication. A 59-year-old male patient who had undergone endoscopic sinus surgery was admitted to the emergency room with severe headache, nausea, and vomiting. Cranial computed tomography revealed pneumocephalus. Endoscopic surgery under general anesthesia was performed again, and a dural tear at the crista galli was identified and repaired using an autograft and fibrin glue. In same session, burr-hole drainage was also performed. He recovered after few days and was discharged. Therefore, following endoscopic sinus surgery, surgeons should be aware of the development of pneumocephalus, a rare but life-threatening complication.