=====Tension pneumocephalus after shunt insertion=====

[[Tension Pneumocephalus]] after [[shunt]] insertion

====Case reports====
===1985===
A case of tension pneumocephalus in association with a ventriculoperitoneal shunt for obstructive hydrocephalus, due to the presence of a pineal tumour. In this unique form of tension pneumocephalus, air from the middle ear must have penetrated into the brain parenchyma and later on into the ventricular system through pre-existing congenital defects in the bony tegmen tympani and the covering dura mater. The possible pathogenetic mechanisms of this kind of tension pneumocephalus are discussed
((Goffin J, Plets C. Tension pneumocephalus in association with
ventriculoperitoneal shunt. Acta Neurochir (Wien). 1985;76(3-4):121-4. PubMed
PMID: 4025016.
)).
===1976===
A case of tension pneumocephalus after the insertion of a ventriculoperitoneal shunt for aqueductal stenosis is reported. The possible mechanisms producing this complication are discussed
((Little JR, MacCarty CS. Tension pneumocephalus after insertion of
ventriculoperitoneal shunt for aqueductal stenosis. J Neurosurg. 1976
Mar;44(3):383-5. PubMed PMID: 1249619.
)).

===1975===
Pitts et al. describe a case of massive pneumocephalus following ventriculoperitoneal shunting for hydrocephalus. After multiple diagnostic and surgical procedures, congenital defects in the [[tegmen tympani]] of both temporal bones were identified as the sources for entry of air. A functioning shunt intermittently established negative intracranial pressure and allowed ingress of air through these abnormalities; when the shunt was occluded, air did not enter the skull, and there was no [[cerebrospinal fluid leakage]]. Repair of these middle ear defects prevented further recurrence of pneumocephalus
((Pitts LH, Wilson CB, Dedo HH, Weyand R. Pneumocephalus following
ventriculoperitoneal shunt. Case report. J Neurosurg. 1975 Nov;43(5):631-3.
PubMed PMID: 1181396.
)).