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The patient was immediately transferred to a neurosurgical department for insertion of an external ventricular drain. Surgical repair of the dural defect was subsequently performed through an endoscopic, endonasal approach using an autologous fascia lata graft. The patient gradually improved over the following days and had made a complete recovery 3\u2009months after surgery.<\/jats:p>","DOI":"10.1136\/bcr-2025-265185","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T15:20:20Z","timestamp":1745335220000},"page":"e265185","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Cognitive dysfunction and decreased level of consciousness due to severe pneumocephalus in granulomatosis with polyangiitis"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0114-7738","authenticated-orcid":false,"given":"Shania","family":"Lashkari","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K\u00e5re","family":"Fugleholm","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niclas","family":"Rubek","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2915-249X","authenticated-orcid":false,"given":"Alexander","family":"Lilja-Cyron","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"2025082707220819000_18.4.e265185.1","doi-asserted-by":"publisher","DOI":"10.1177\/0394632015617063"},{"key":"2025082707220819000_18.4.e265185.2","unstructured":"Jennette JC , Falk RJ , Bacon PA , et al . 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