From the FDA Drug Label
1 INDICATIONS & USAGE Mannitol Injection is indicated for the following purposes in adults and pediatric patients. Therapeutic Use Reduction of intracranial pressure and brain mass.
The treatment for Tension Pneumocephalus may involve reducing intracranial pressure.
- Mannitol (IV) can be used for the reduction of intracranial pressure and brain mass 1.
From the Research
Tension pneumocephalus requires immediate treatment through a combination of surgical intervention and supportive care, with the primary treatment being urgent neurosurgical decompression, typically by drilling burr holes or performing a craniotomy to release the trapped air and relieve intracranial pressure, as recommended by the most recent study 2. The treatment of tension pneumocephalus involves several key steps, including:
- Urgent neurosurgical decompression to release the trapped air and relieve intracranial pressure
- Repairing dural defects using autologous grafts, fibrin glue, or synthetic dural substitutes to prevent further air entry
- Positioning the patient supine with the head elevated at 30 degrees to minimize intracranial pressure
- Administering supplemental oxygen at 100% concentration to facilitate nitrogen washout and accelerate air resorption
- Prophylactic broad-spectrum antibiotics, such as ceftriaxone (2g IV every 12 hours) plus metronidazole (500mg IV every 8 hours), if CSF leak or contamination is suspected
- Anticonvulsants, like levetiracetam (500mg IV twice daily), if seizures occur
- Close neurological monitoring in an ICU setting with serial imaging to assess resolution, as highlighted in the study 2. Tension pneumocephalus is a life-threatening condition that can cause increased intracranial pressure, brain compression, and potential herniation if not promptly treated, as noted in the study 3. The use of computed tomography of the brain is essential for diagnosis, and immediate neurosurgical consultation with decompression is the treatment of choice, as recommended by the study 2.