We report the clinical case report of a 67-year-old patient with diagnoses of hypertension, ischemic heart disease and a previous history of Acute Myocardial Infarction (AMI) and nonspecific signs and symptoms (general illness, weight loss, hyporexia, fever, impressive edema at the feet, systemic arterial hypotension). So, we performed a series of laboratory, radiological and instrumental examinations, but the clinical picture remained difficult to interpret. The echocardiographic evaluation led us to a suspicion of infiltrative heart disease, and the magnetic resonance, while confirming the interesting data observed at the ultrasound exam. Therefore, we decided to perform a biopsy, which appeared positive for our suspicion. So, we thought we did not waste any more precious time and, after stabilizing the patient, we sent our patient to a specialized diagnostic center for diagnostic confirmation and the beginning of targeted therapies. Clinical, laboratory and instrumental implications of this differential diagnosis are discussed.

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Pneumocephalus or air within the cranial vault is usually associated with a series of symptoms caused by head trauma, the presence of neoplasms or after craniofacial surgical interventions or other causes. We report a case report of an elderly patient who presented with postural instability with an anamnestic history that didn't talk about traumatic events. We review briefly the literature for nontraumatic causes causes of pneumocephalus, its symptoms and clinical manifestations and finally the therapy.