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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  • During the management of 43 cases in the last 5 years [unpublished], we conclude that 100% oxygen therapy or bed flat position did not significantly affect the outcome of therapy though theoretically it may result in early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.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.


Articles from Asian Journal of Neurosurgery are provided here courtesy of Wolters Kluwer -- Medknow Publications