Disseminated pneumocephalus secondary to air compressor injury

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We report an unusual case of a young male patient who presented with severe pain and swelling of his left eyelid following an air compressor tip accident. He suffered extensive facial edema accompanied by deep tissue emphysema and an elevated intraocular pressure. On noncontrast CT scan, air was detected in the intraconal and extraconal orbital compartments, and intracranially within the subarachnoid spaces as well as in the suprasellar and perimesencephalic cisterns. There were no detectable fractures. We presume that by perforating the orbital septum, Tenon’s capsule, and the optic nerve sheath, air had managed to penetrate the cranium through the optic nerve subarachnoid space and into the intracranial subarachnoid space.

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  1. 1.

    Adler JS, Graeb DA, Nugent RA (1992) Inadvertent intracranial placement of a nasogastric tube in a patient with severe head trauma. Can Med Assoc J 147:668–669

  2. 2.

    Bakay L, Glasauer FE (1980) Head injury. Little Brown, Boston

  3. 3.

    Dabdoub CB, Salas G, Silveira E et al (2015) Review of the management of pneumocephalus. Surg Neurol Int 6:155

  4. 4.

    Hage P, Daou B, Jabbour P (2015) Spontaneous otogenic pneumocephalus due to altitude changes: a case report and review of literature. Clin Neurol Neurosurg 138:162–164

  5. 5.

    Huh J (2013) Barotrauma-induced pneumocephalus experienced by a high risk patient after commercial air travel. J Korean Neurosurg Soc 54:142–144

  6. 6.

    Karavelioglu E, Eser O, Haktanir A (2014) Pneumocephalus and pneumorrhachis after spinal surgery: case report and review of the literature. Neurol Med Chir 54:405–407

  7. 7.

    Lunsford LD, Maroon JC, Sheptak PE et al (1979) Subdural tension pneumocephalus. Report of two cases. J Neurosurg 50:525

  8. 8.

    Mahabir RC, Szymczak A, Sutherland GR (2004) Intracerebral pneumatocele presenting after air travel. J Neurosurg 101:340–342

  9. 9.

    Mattick A, Goodwin P (2005) Mount Fuji sign on CT following trauma. J Trauma 59:254

  10. 10.

    Ratilal B, Costa J, Sampaio C (2006) Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures. Cochrane Database Syst Rev. 2006;(1):CD004884.

  11. 11.

    Webber-Jones JE (2005) Tension pneumocephalus. J Neurosci Nurs 37:272–276

  12. 12.

    Williams TR, Frankel N (1999) Intracerebral air caused by conjunctival laceration with air hose. Arch Ophthalmol 117:1090–1091

  13. 13.

    Yildiz A, Duce MN, Ozer C et al (2002) Disseminated pneumocephalus secondary to an unusual facial trauma. Eur J Radiol 42:65–68

  14. 14.

    Zeba I, Barkovic I, Knezevic S, Lender DM et al (2010) Pneumocephalus after an uneventful scuba dive. Aviat Space Environ Med 81:511–513

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Correspondence to H Suisa.

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This article is part of the Topical Collection on Brain trauma

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Suisa, H., Sviri, G. Disseminated pneumocephalus secondary to air compressor injury. Acta Neurochir (2020) doi:10.1007/s00701-019-04184-w

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  • Pneumocephalus
  • Air compressor
  • Barotrauma
  • CSF leak
  • Blow gun
  • Intraocular pressure