Abstract
A 55-year-old man with recurrent nasopharyngeal carcinoma presented with intractable headaches and intermittent rhinorrhoea for 2 weeks. CT showed severe destruction of the skull base by the tumour. The headache persisted despite intraventricular morphine. On the 29th hospital day, sudden onset of neurological deterioration led to coma, and CT revealed tension pneumocephalus due to nasopharyngeal carcinoma breaking through the skull base. The literature on pneumocephalus is reviewed and the aetiology discussed.
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Chiari H (1884) Ueber einen Fall von Luftansammlung in den Ventrikeln des menschlichen Gehirns. Z Heilkd 5: 383–390
Luckett WH (1913) Air in the ventricles of the brain, following a fracture of the skull: report of a case. Surg Gynecol Obstet 17: 237–240
Markham JW (1967) The clinical features of pneumocephalus based upon a survey of 284 cases with report of additional cases. Acta Neurochir 16: 1–78
Arbit E, Shah J, Redford R (1991) Tension pneumocephalus: treatment with controlled decompression via a closed water-seal drainage system. J Neurosurg 74: 139–142
Betz H, Prager P (1981) Spontaneous pneumatocele during radiation of a giant meningosarcoma. Neuroradiology 22: 159–161
Bremer AM, Nguyen TQ (1982) Tension pneumocephalus after surgical treatment of chronic subdural hematoma: a report of three cases. Neurosurgery 11: 284–287
Davis DH, Laws ER Jr, McDonald TJ (1981) Intraventricular tension pneumocephalus as a complication of paranasal sinus surgery. Neurosurgery 8: 574–576
Goldman RW (1986) Pneumocephalus as a consequence of barotrauma. JAMA 255: 3154–3156
Pitt TE (1982) Intracranial aerocele in facial injury. Med J Aust 1: 499–502
Raggio JF, Fleischer AS, Sung UF (1979) Expanding pneumocephalus due to nitrous oxide anesthesia: case report. Neurosurgery 4: 261–263
Taguchi Y, Sato J, Nakamura N (1981) Gas-containing brain abscess due toFusobacterium nucleatum. Surg Neurol 16: 408–410
Walker FO, Vern BA (1986) The mechanism of pneumocephalus formation in patients with CSF fistulas. J Neurol Neurosurg Psychiatry 49: 203–205
Clark JB, Six EG (1984) Epidermoid tumor presenting as tension pneumocephalus. J Neurosurg 60: 1312–1314
Isler RJ, Weber AL (1978) Pneumocephalus from paranasal sinus carcinoma. Ann Otol 87: 142–143
Kinsley S, Dougherty J (1993) Tension pneumocephalus related to an epidermoid tumor of ethmoid sinus origin. Ann Emerg Med 22: 259–61
Wilson ES Jr, Sheft DJ (1986) Epidermoid tumor of the skull with intracranial pneumatocele: case report. J Neurosurg 28: 600–602
Neel HB III (1985) Nasopharyngeal carcinoma: clinical presentation, diagnosis, treatment, and prognosis. Otolaryngol Clin North Am 18: 479–493
Lishner M, Perrin RG, Feld R, et al (1990) Complication associated with Ommaya reservoirs in patients with cancer. Arch Intern Med 150: 173–176
Obbens EAMT, Leavens ME, Beal JW, et al (1985) Ommaya reservoirs in 387 cancer patients: a 15-year experience. Neurology 35: 1274–1278
Bedwinek JM, Skukovsky IJ, Fletcher GH, et al (1976) Osteonecrosis in patients treated with definitive radiotherapy for squamous cell carcinomas of oral cavity and naso- and oropharynx. Radiology 119: 665–667
Morrish R, Chan E, Silverman S, et al (1981) Osteoradionecrosis in patients irradiated for head and neck carcinoma. Cancer 47: 1980–1983
Frankel M, Faley D, Alker G (1980) Otogenic pneumocephalus secondary to chronic otitis media. Arch Otolaryngol 196: 437–439
Gilbert A, Tolmach R, Farrell J (1961) Gas gangrene of the brain. Am J Surg 101: 366–369
Osborn AG, Daines JH, Wing SD (1978) Intracranial air on computerized tomography. J Neurosurg 48: 355–359
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Kiu, M.C., Wan, Y.L., Ng, S.H. et al. Pneumocephalus due to nasopharyngeal carcinoma: case report. Neuroradiology 38, 70–72 (1996). https://doi.org/10.1007/BF00593227
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DOI: https://doi.org/10.1007/BF00593227