Tension pneumocephalus is an acute and possibly life threatening neurological emergency that can occur in setting of head trauma, instrumentation and relatively uncommon post operative neurosurgical complication that can result in build up of air inside the head causing pressure build up that can have a mass effect on the brain.

Diagnosis is made with head CT imaging which demonstrates a classic radiological sign called the Mount Fuji sign and represents the famous mountain in Japan due to the appearance of the compressed brain in the frontal poles. A treatment for this is urgent placement of a drain to allow shunting of air and other serosanguineous products.

In this painting you can see the classic Mount Fuji in the backdrop of Japanese foliage, and the lake in front has a channel at the bottom of the painting that almost appears to be draining the lake off the canvas.