Pneumocephalus in a Pediatric Patient with Glioma Receiving Trametinib

Hamza Gorsi, Neena I. Marupudi, Sandeep Sood, Deniz Altinok, Maxim Yankelevich

Research output: Contribution to journalArticlepeer-review


The mitogen-activated protein kinase (MAPK) pathway consists of the Ras/Raf/MEK/ERK signaling cascade, and its upregulation plays a major role in the pathogenesis of pediatric astrocytomas and molecular inhibitors of this pathway including trametinib and dabrafenib have been tested in early-phase clinical trials and used by pediatric oncologists in children with BRAF-mutated gliomas. We report a clinical case where a child with progressive BRAF-mutated glioma developed an uncommon and difficult to manage complication - pneumocephalus from intracranial air entry and trapping through dehisced surgical wounds and preexisting skull burr holes. The patient's wound breakdown coincided with skin toxicity from MEK inhibitor therapy. With increasing use of targeted molecular inhibitors in pediatric neuro-oncology, this case illustrates the potentially complicated course of MEK inhibitor therapy in patients with scalp surgical wounds and burr holes that were placed within few weeks from initiation of drug therapy, especially if patients have additional factors that can contribute to poor wound healing such as use of steroids and malnutrition.

Original languageEnglish
Pages (from-to)51-53
Number of pages3
JournalPediatric Neurosurgery
Issue number1
StatePublished - Mar 1 2020


  • MEK inhibitors
  • Pediatric glioma
  • Pneumocephalus


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