Spontaneous epidural pneumocephalus.

Abstract

A 20-year-old male presented with an extremely rare spontaneous epidural pneumocephalus which was successfully treated by a single neurosurgical intervention. The patient had a habit of nose blowing and a 1-year history of progressive headache and nausea. Cranial computed tomography (CT) revealed a 2 x 7 cm right temporo-occipital epidural pneumocephalus with extensive hyperpneumatization of the mastoid cells. Right temporo-occipital craniotomy with a right superficial temporal artery and vein flap repair resulted in radiographic resolution of the pneumocephalus, and he remained neurologically free of symptoms at 1-year follow-up examination. Early identification and monitoring of symptomatic pneumocephalus followed by decompression and prevention of infection via closure of the bone defect can avoid possible serious consequences. The underlying mechanisms may involve a congenital petrous bone defect and a ball-valve effect due to excessive nose blowing in our case.

• Authors: Adam Tucker, Hiroji Miyake, Masao Tsuji, Tohru Ukita, Kentaro Nishihara, Seiko Ito, Takehisa Ohmura
• Journal: Neurologia medico-chirurgica (Neurol Med Chir (Tokyo)) Vol. 48 Issue 10 Pg. 474-8 (Oct 2008) ISSN: 1349-8029 [Electronic] Japan
• PMID: 18948684 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Craniotomy
• Epidural Space (diagnostic imaging, pathology, surgery)
• Headache (etiology)
• Humans
• Intracranial Hypertension (complications, etiology)
• Male
• Mastoid (diagnostic imaging, pathology)
• Petrous Bone (diagnostic imaging, pathology)
• Pneumocephalus (diagnostic imaging, etiology, pathology)
• Surgical Flaps
• Temporal Arteries (anatomy & histology, surgery)
• Temporal Bone (diagnostic imaging, pathology, surgery)
• Tomography, X-Ray Computed
• Treatment Outcome