Spontaneous pneumocephalus of an otogenic origin

Vallejo, Luis A.; Gil-Carcedo, Luis M.; Borrás, Jose Maria; Campos, José M. de

doi:10.1016/s0194-5998(99)70080-x

Cited by 35 publications

(45 citation statements)

References 13 publications

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“…4,11,20) In theory, however, the formation of an epidural pneumocephalus is unlikely to be caused by negative pressure alone because the dura is very adherent to the bone particularly in the parieto-occipital area of the cranium. 8,19) In our case the precise underlying mechanism for the development of pneumocephalus remains unknown. The ball-valve effect 14) seems to be a possible mechanism as the patient had a history of excessive nose blowing which could have produced pressure changes significant enough to result in hyperpneumatization and fistulous trapping of intracranial air.…”

Section: Discussionmentioning

confidence: 78%

“…Several causes of this pressure effect have been proposed (Table 3), including loss of CSF through a dural leak (inverted bottle or siphon effect), 5,8) postural changes (suction effect), 21) or fluctuations in nasopharyngeal air pressure due to sneezing, coughing, Valsalva's maneuver, etc (ball-valve effect). 19) In some cases of spontaneous pneumocephalus there were no clear identifiable causes, but abnormally low or negative intracranial pressure may lead to air entrapment 14) as in a similar mechanism found in cases of postoperative shunt placement. 4,11,20) In theory, however, the formation of an epidural pneumocephalus is unlikely to be caused by negative pressure alone because the dura is very adherent to the bone particularly in the parieto-occipital area of the cranium.…”

Section: Discussionmentioning

confidence: 99%

“…9) Many cases of spontaneous pneumocephalus have been reported in the literature but only 9 cases were epidural in location (Table 1). 1,6,7,12,13,15,16,19) We describe a chronically symptomatic young patient with a giant spontaneous epidural pneumocephalus who was successfully treated by a single neurosurgical intervention.…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous Epidural Pneumocephalus -Case Report-

Tucker

Miyake

Tsuji

et al. 2008

Neurol. Med. Chir.(Tokyo)

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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 × 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.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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Spontaneous Epidural Pneumocephalus -Case Report-

Tucker

Miyake

Tsuji

et al. 2008

Neurol. Med. Chir.(Tokyo)

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“…(1,4,8,10,12,15,16,18,20,22,26,28,29) Symptoms: The most common presenting symptom was severe headache. Other symptoms include aural fullness, otalgia, ear crepitations.…”

Section: Discussionmentioning

confidence: 99%

“…With 'ball valve' effect air could get accumulated intracranially over a period of days to weeks. (11,12,19,20,26) Two pathological conditions must co-exist: A. Defect in temporal bone, B.Gradient of pressure between middle ear and intracranial space to allow the air to enter the cranium.…”

Section: Mechanismmentioning

confidence: 99%

A spontaneous Pneumocephalus and Hyperpneumatisation of occipital bone and atlas vertebra: a case report.

Sawant¹

2016

IOSR

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Spontaneous otogenic intracerebral pneumocephalus: case report and review of the literature

Krayenbühl

Alkadhi

Jung

et al. 2004

Eur Arch Otorhinolaryngol

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Pneumocephalus is commonly associated with head and facial trauma, ear infection or surgical interventions. We describe the rare case of a spontaneous pneumocephalus arising from lateral mastoid air cells. A 48-year-old man presented with a 10-day history of sudden, repetitive, 'hammering-like' acoustic sensations in his left ear that were followed by word-finding difficulties and loss of vision in the right visual field. Imaging revealed a large, left temporal pneumatocele associated with a small acute intracerebral hemorrhage. Left temporal and subtemporal craniotomy and decompression were performed. Further exploration confirmed a dural and osseous defect in the anterolateral surface of the mastoid that was consecutively closed watertight. Although extremely rare, a spontaneous pneumocephalus with mastoidal origin should be considered as a possible diagnosis in patients with suggestive acoustic phenomena and other non-specific neurological symptoms.

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Spontaneous pneumocephalus of an otogenic origin

Cited by 35 publications

References 13 publications

Spontaneous Epidural Pneumocephalus -Case Report-

Spontaneous Epidural Pneumocephalus -Case Report-

A spontaneous Pneumocephalus and Hyperpneumatisation of occipital bone and atlas vertebra: a case report.

Spontaneous otogenic intracerebral pneumocephalus: case report and review of the literature

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