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Asian J Neurosurg. 2017 Jan-Mar; 12(1): 148.
PMCID: PMC5379794

Pneumocephalus is not a serious outcome after surgery for chronic SDH

I wish to congratulate Zidan Ihab for the publication of the article “Pneumocephalus after surgical evacuation of chronic subdural hematoma: Is it a serious complication?” in Vol. 7, Issue 2, April- June, 2012. However, it was not clear as to how the study concluded on any new contribution in the management of chronic sub dural hematoma (Ch SDH). From my personal experience, I wish to contribute the following:

  • Pneumocephalus after surgery for Ch SDH has never been a serious complication but an obvious outcome of the procedure with no significant consequence
  • Ch SDH and its management should no longer be associated with mortality or significant morbidity other than in conditions of multisystem involvement
  • During the management of 43 cases in the last 5 years [unpublished], we conclude that 100% oxygen therapy or bed flat position did not significantly affect the outcome of therapy though theoretically it may result in early resolution of the pneumocephalus
  • Preventing dehydration rather than overhydration was more effective in favorable outcome.

In conclusion, I hope a similar study involving a larger number of patients would be conducted to reevaluate the role of 100% oxygen supplementation and decubitus with its implications in rural semirural segment of the world.

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