Overview Of A Case Of Spontaneous Non-Traumatic Pneumocephalus Extending To Ventricles

摘要

Spontaneously occurred Pneumocephalus is rarely found. Extension of the air bubbles into the ventricles is far more rare. For cases, complaining of abrupt attack of intense headache, a rare condition of extra dural, subdural and subarachnoid, intracerebral, and intra ventricular pneumocephalus with defect in the sinus wall could be considered as a possible etiology. Here we present a patient with dilated frontal sinus reported with spontaneous pneumocephalus extending to ventricles and extra cerebro spinal fluid (CSF) spaces with an overview of this rare condition.PSD- Pneumosinus dilatantsCSF -Cerebro Spinal Fluid Introduction Definition of pneumocephalus is presence of air intra-cranially. Spontaneous and atraumatic pneumo-cephalus is not a common aetiology (0.6%)2,3 . Pneumosinus dilatans (PSD)1,2 is a condition of abnormally hypertrophied paranasal air sinus without any radiological findings of destruction local bone cortex or thickening mucous membrane. Other common causes of pneumocephalus are barotraumas, valsalva maneuvers,3,4.A case report of spontaneous pneumocephalus extending to ventricles and extra cerebral CSF spaces along with PSD is described here. Report of Case An Indian housewife, 46 years old, was brought to in KPC Medical College and Hospital, Kolkata, India, with syncope and excruciating headache. Following a severe bout of cough due to common cold and pharyngitis, the lady developed abrupt intense headache. There was no history of recent trauma or any cranial surgical intervention.Thorough physical examination by physicians of internal medicine and neurology and consultants could not find any abnormality except that she had fever of 38.8 Celsius (102 degrees Fahrenheit)To rule out intracranial pathology CT scan was done. It showed multiple small air bubbles (Densities -1000 and above HU) in sylvian fissures subdural and extra axial CSF spaces, perisellar & peri ganglionic regions and within the ventricles.(Figures 1,2,3).