Iatrogenic Pneumocephalus Presenting as Seizure: A Rare Case Report

İlknur Sümeyye Yılmaz¹, Kudret Selki¹, Salih Karakoyun1, Mustafa Boğan²

Keywords: Pneumocephalus, intracranial air, craniotomy, seizure

DOI: 10.63475/yjm.v4i2.0196

DOI URL: https://doi.org/10.63475/yjm.v4i2.0196

Publish Date: 22-09-2025

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Pages: 460 - 462

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Downloads: 2

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Author Affiliation:

1 Research Asistant, Emergency Department, School of Medicine, Düzce University, Düzce, Turkey
2 Consultant, Emergency Department, School of Medicine, Düzce University, Düzce, Turkey

Abstract

Pneumocephalus is a rare condition characterized by the presence of intracranial air, most commonly seen after head trauma or surgery. Although it is often asymptomatic, it can lead to serious complications such as tension pneumocephalus and seizures. This study presents a case of iatrogenic pneumocephalus and seizures that developed after a flap rotation operation in a patient with a history of craniotomy. An 82-year-old male patient presented to the emergency department shortly after flap rotation surgery with loss of consciousness and generalized tonicclonic seizures. Brain computed tomography revealed a left temporal bone defect and epidural air collection. Diffusion magnetic resonance imaging showed no acute ischemic lesion. The patient was initially started on levetiracetam, but due to side effects, he was switched to a combination of valproate and lamotrigine. The patient developed pneumonia during follow-up and was treated in the intensive care unit and discharged in stable condition. In patients who have previously undergone craniotomy, the risk of pneumocephalus should be considered even in minor surgical procedures, and early imaging should be performed when new neurological symptoms develop.

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