Intensive Care Med (2017) 43:1409–1410 DOI 10.1007/s00134-017-4866-1 IM AGING IN INTENSIVE C ARE MEDICINE Noninvasive positive pressure ventilation after skull base surgery 1 1 2 1* Armel Bettan , Pierre‑André RodieT ‑ albere , Stéphane André Martin and Karim Lakhal © 2017 Springer‑ Verlag GmbH Germany and ESICM This patient was treated with noninvasive positive pres - No cerebrospinal fluid rhinorrhea has been reported in sure ventilation (NIPPV) with nasal mask for obstruc- the aftermath. tive sleep apnea. He recently underwent a resection of At day 9, meningitis was suspected and, at day 12, a chondrosarcoma of the petrous part of the temporal NIPPV was intensified because of hypercapnia and an bone. Surgery used an anterior petrosectomy (fronto- altered state of consciousness related to opioid overdose. temporal incision). Biomedical glue replaced the tumor CT scan revealed a major subdural tension pneumoceph- in the extradural space and sealing of the dura mater was alus. The compressed frontal lobes adopt the silhouette of done by suturing and adjunction of a fibrinogen–throm - a volcano, the so-called Mount Fuji sign (Fig. 1a). An air bin patch for the prevention of cerebrospinal fluid leaks. bubble (arrow) suggests that air penetrated the subdural Fig. 1
Intensive Care Medicine – Springer Journals
Published: Jun 22, 2017
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