Objectives: To determine the incidence, associated factors, distribution, and degrees of acute post-surgical pneumocephalus in patients with cranioencephalic pathology operated on in the supine and prone position.

Methods: Observational, prospective, and cross-sectional study in patients 18 years of age or older, with cranioencephalic pathology belonging to the Neurosurgery Service of the Cayetano Heredia National Hospital, March 2022 - February 2023. All were operated in the supine or prone position. Acute (<= 72hrs) post-surgical pneumocephalus was identified by brain tomography. Those with pre-surgical pneumocephalus and operated on in positions other than supine and prone were excluded.

Results: Of 100 patients with cranioencephalic pathology who underwent surgery in the supine and prone position, 54% were male and 56% were under 60 years of age. In addition, 56% presented some comorbidity, and 54% had non-traumatic cranioencephalic pathology. The entire population presented some patterns of distribution and degree of postoperative acute pneumocephalus. There were no deaths from pneumocephalus. There was an association (p<0.005) between some distributions of pneumocephalus with the female sex, traumatic cranioencephalic pathology, and the creation of a surgical access to some intracranial space. In the same way, an association (p<0.005) was evidenced between the degrees of pneumocephalus of some intracranial space with the surgical opening towards this or another deeper space.

Conclusions: Acute post-surgical pneumocephalus is frequent in patients with cranioencephalic pathology operated on in supine and prone positions. The distribution and degrees of pneumocephalus may be related to sex, the type of cranioencephalic pathology, and the depth of the surgical lesion.

     Keywords: Pneumocephalus, Prone Position, Intraoperative Complications, Neurosurgery. (Source: MeSH NLM)