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Penny For Your Thoughts
Oct 5, 1998

Hi Doctor Holodniy, About 29 months ago, i was rushed into emergency craniotomy surgery after a skull fracture and subsequent epidural hematomas. I decided to order my records, for my own use, and stumbled upon a few things which were NEVER discussed with me, i'd like your opinion. First, i read something about minimal Pneumocephalus in the area of hemorrhage, what is this? Any big dea? Some CBC results i'd like your feelings on. First, WBC count 11.10.. Netrophil # 10.10... neutrophil% 90.10, Segmented Neut 84, Lymphs on the low end..anything here i should worry about? thank you

Response from Dr. Holodniy

Pneumocephalus literally means air in your head. This can be seen on CT or MRI scans of the head after brain surgery. Usually we don't have air pockets inside our head. But to get to the brain, we have to make a hole in the skull which results in some air getting inside. It then gets absorbed and disappears. Depending on when the WBC results were obtained, those results could be very normal. The usual WBC count is about 5-10 (x 1000). 11 is just a little high. The neutrophil count is usually 50-70% of the total WBC count. In times of stress (brain surgery is a big one), the neutrophil count will go up (>70%) and the lymphocyte count will go down temporarily. This is quite common.

MH



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