Pneumocephalus is a common complication presented as air in the cranial cavity after cranial surgery. We present a very rare case of isolated new onset aphasia due to pneumocephalus after evacuation of subdural hematoma (SDH). Tension pneumocephalus presenting as isolated aphasia has not been reported earlier although associated paresis has been reported. We present the case of a 13-year-old male child with a history of fall before the onset of symptoms like headache and vomiting. The immediate MRI of the brain showed left-sided frontotemporoparietal subacute SDH with significant midline shift and subfalcine herniation. The child was subsequently managed with craniotomy and evacuation of hematoma with duraplasty. The patient developed aphasia on second-day post-surgery which progressed from moderate to severe aphasia by day 4. Computed tomography (CT) scan revealed pneumocephalus and an increase in the pneumocephalus in imaging on post-op day 4 with no other abnormalities. The condition was then managed by removing the subgaleal drain and administering high flow oxygen of 10 l/min. This case signifies the importance of proper diagnosis of new-onset neurological deficits after evacuation of subdural hematoma for the better outcome.

中文翻译：

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硬膜下血肿（SDH）撤离后因张力性肺炎引起的孤立性失语的极少数情况：一例

颅脑手术是颅脑手术后常见的并发症，表现为颅腔内的空气。我们提出了一个非常罕见的案例，由于硬脑膜下血肿（SDH）撤离后由于气脑炎而导致新发的失语症。尽管已经报告了相关的轻瘫，但尚未报道过表现为孤立性失语的张力性气脑。我们介绍了一个13岁男孩的案例，该男孩在头痛和呕吐等症状发作之前有跌倒史。脑部即时MRI显示左侧额颞颞顶亚急性SDH，伴有明显的中线移位和次f性疝。随后对该儿童进行了开颅手术，并通过硬膜成形术清除了血肿。该患者在术后第二天出现失语，到第4天从中度失语发展为严重失语。计算机断层扫描（CT）扫描显示在术后第4天成像时出现了肺气肿并显着增加了肺气肿，没有其他异常。然后通过移走galgal下引流并给予10 l / min的高流量氧气来控制病情。该病例表明硬膜下血肿清除后正确诊断新发神经系统缺陷的重要性。