Journal of Acute Care

Register      Login

VOLUME 1 , ISSUE 1 ( January-April, 2022 ) > List of Articles


Mount Fuji Sign: Pneumocephalus Following Burr-hole Evacuation of Subdural Hematoma

Pradeep Hiremath

Keywords : Postneurosurgery complication, Subdural hematoma evacuation, Tension pneumocephalus

Citation Information : Hiremath P. Mount Fuji Sign: Pneumocephalus Following Burr-hole Evacuation of Subdural Hematoma. 2022; 1 (1):39-40.

DOI: 10.5005/jp-journals-10089-0010

License: CC BY-NC 4.0

Published Online: 12-07-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Introduction: The Mount Fuji sign is a common sign of tension pneumocephalus, usually occurring after surgical evacuation of subdural hematomas (SDHs). It may be suspected when such postsurgical patients present with headache or vomiting or other neurological signs and is diagnosed by computed tomography (CT) scan of the brain. It usually occurs within the immediate postoperative period but may rarely be seen even months after the surgery. Case report: We present the case of a 69-year-old male who developed a subdural collection of air, following surgery to evacuate a subdural hematoma. Conclusion: The patient was successfully treated with conservative measures including administering 100% oxygen, adequate analgesia and Fowler's position. However, severe neurological symptoms such as seizure or obtundation warrants emergency decompression.

  1. Ishiwata Y, Fujitsu K, Sekino T, et al. Subdural tension pneumocephalus following surgery for chronic subdural hematoma. J Neurosurg 1988;68(1):58–61. DOI: 10.3171/jns.1988.68.1.0058
  2. Ihab Z. Pneumocephalus after surgical evacuation of chronic subdural hematoma: is it a serious complication? Asian J Neurosurg 2012;7(2):66–74. DOI: 10.4103/1793-5482.98647
  3. Dandy WE. Pneumocephalus (intracranial pneumatocele or aerocele) Arch Surg 1926;12(5):949–948. DOI: 10.1001/archsurg.1926. 01130050003001
  4. Horowitz M. Intracranial pneumocoele. An unusual complication following mastoid surgery. J Laryngol Otol 1964;78:128–134. DOI: 10.1017/s0022215100061910
  5. Hong WJ, Yoo CJ, Park CW, et al. Two cases of delayed tension pneumocephalus. J Korean Neurosurg Soc 2005;37(1):59–62.
  6. Wang A, Solli E, Carberry N, et al. Delayed tension pneumocephalus following gunshot wound to the head: a case report and review of the literature. Case Rep Surg 2016;2016:7534571. DOI: 10.1155/2016/7534571
  7. Governale LS, Gormley WB, Aglio LS. Anesthetic and intensive care management of the patient with a meningioma. In: Pamir NM, Black PM, Fahlbusch R, editors. Meningiomas. W.B. Saunders; 2010. pp. 297–309. DOI: 10.1016/B978-1-4160-5654-6.00020-9. ISBN 9781416056546.
  8. El-Sayed IH, Saleh HMA, McDermott MW. Neurosurgical complications. In: Eisele DW, Smith RV, editors. Complications in Head and Neck Surgery. 2nd ed. Mosby; 2009. pp. 119–132. DOI: 10.1016/B978-141604220-4.50014-6. ISBN 9781416042204.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.