On first evaluation (Figure 1), at her origin city, she was submitted to a brain Computed Tomography (CT) showing an assymmetric lateral pneumoventricle, with a prominent right frontal horn, and sign of transependymal edema.
She was promptly submitted to further evaluation, evidencing a discrete increase in the pneumoventricle on brain CT, and confirming a planum sphenoidal meningocele on skull base fine cuts CT (Figure 2).
Postoperative CT scan showed improvement of pneumoventricle and reduction of frontal mass effect (Figure 7).
In its turn, pneumoventricle is not so common, excepting those postoperative, mainly after posterior fossa approaches in sitting position (pineal tumors, midbrain lesions 12), or transventricular approaches (intraventricular tumors, thalamic lesions, colloid cysts), or endoscopic surgeries 4 (third ventriculostomy, septostomy, aqueductoplasty).
Spontaneous pneumoventricle is a rare condition, almost always related to CSF leakage, Valsalva's maneuver 5, chronic cough, long airplane trips 10, or deep diving.
However, CSF leakage or pneumoventricle following, whether related or not, bariatric surgery has never been reported.
Spontaneous pneumoventricle is a rare neurosurgical condition, to which most neurosurgeons are not familiarized.
Tension pneumoventricle following exposure of shunt chamber.