Introduction.
Tension pneumocephalus (TP) is a very rare complication related to
radiotherapy for
nasopharyngeal carcinoma (NPC). Case Presentation. A 46-year-old man was admitted to the hospital with an altered mental status and aqueous
rhinorrhea for several hours of evolution. The computed tomography (CT) scan showed TP, a defect in the skull base and nasocranial
fistula. The patient was receiving a second course of
radiotherapy for local relapse. With medical treatment the patient recovered neurological status but died two days later. Discussion. In our knowledge, only 4 cases with similar characteristics have been reported in the literature. This is the first case report of TP during
radiotherapy. TP was an abrupt and rapid process with neurological impairment for hours of evolution without suspicious
osteoradionecrosis (OR) in previous scan images. The defect in the skull base could be due to a rapid disappearance of the
tumor. The appearance of aqueous
rhinorrhea and neurological symptoms must be viewed as signs of alarm.