Asian Journal of Case Reports in Surgery

External Lumbar Drainage: An Acceptable Treatment for Traumatic Tension Pneumocephalus with Cerebrospinal Fluid Otorrhea

Nur Bazlaah Binti Bahari *

Hospital Cancelor Tunku Mukhriz, HUKM, Malaysia and Department of Neurosurgery, Hospital Sungai Buloh, Selangor, Malaysia and Department of General Surgical, Hospital Selayang, Malaysia.

Dineesh A. L. P. Venudas

Department of Neurosurgery, Hospital Sungai Buloh, Selangor, Malaysia.

Raden Nadhirah Aishah Binti Hambali

Department of General Surgical, Hospital Selayang, Malaysia.

Nurul Najwa Binti Nazri

Department of Otorhinolaryngology, Hospital Cyberjaya, Malaysia.

*Author to whom correspondence should be addressed.

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Abstract

Traumatic tension pneumocephalus (TTP) can be either asymptomatic or associated with cerebrospinal fluid (CSF) otorrhea or rhinorrhoea. TTP is a diagnosis conventionally made by radiological due to a variety of clinical presentation. TTP can be either be treat by conservative or invasive therapeutic approach. We describe a case in which external lumbar drainage (ELD) was performed to treat concomitant post-traumatic CSF otorrhea following TTP. He was diagnosed with TTP based on radiological findings on 6-hour post-trauma and developed persistent right CSF otorrhea at post-trauma day 5 requiring CSF diversion. However, to the best of our knowledge, there has been no case of TTP with CSF otorrhea treated with ELD as an invasive therapeutic approach. The patient had a good outcome and the CSF otorrhea resolved after 3 days of insertion.

Keywords: Traumatic tension pneumocephalus with CSF otorrhea, external lumbar drainage

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