{"id":"63932c58-7d22-487e-a406-d80e5d7ec21e","slug":"tension-pneumoventricle-in-a-patient-with-a-ventriculoperitoneal-shunt-and-an-ethmoidal-meningoencephalocele","title":"Tension pneumoventricle in a patient with a ventriculoperitoneal shunt and an ethmoidal meningoencephalocele","authors":["Orlando De Jesus","Ricardo J. Fernández-de Thomas","Caleb Feliciano"],"abstract":"Background: Tension pneumoventricle is a rare, life-threatening complication. It has been rarely described in patients with ventriculoperitoneal (VP) shunts. Case Description: A 28-year-old male patient with a VP shunt became progressively lethargic after falling from his wheelchair. Skull X-rays and head CT scan showed abundant air inside the ventricles. He was taken to the operating room, and the shunt was revised without improvement. Two days later, a frontal external ventricular drain was placed to remove the air. In the investigation toward the etiology of the pneumoventricle, a review of previous head CT scans and brain MRIs showed that the patient had a small left frontonasal meningoencephalocele extending into the ethmoid, which had been unnoticed. He underwent repair of the defect with adequate sealing of the frontal skull base. Conclusion: In a shunted patient with moderate or severe symptoms from a tension pneumoventricle, external ventricular drainage is required to remove the air as the shunt is inadequate.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/63932c58-7d22-487e-a406-d80e5d7ec21e/featured/hero-1781561364517.png","publishDate":"2022-05-13T00:00:00.000Z","doi":"10.25259/SNI_64_2022","categories":["Unique Case Observations","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2022/05/11589/SNI-13-202.pdf"}