Pneumocephalus following sinus surgery

Case contributed by Maxime St-Amant
Diagnosis certain

Presentation

Headache.

Patient Data

Age: 55
Gender: Female

Extensive pneumocephalus is demonstrated throughout the intracranial compartment with some posterior sagging of the brain. 

Annotated image

Extensive subarachnoid pneumocephalus ( * ) results in posterior sagging of the brain (yellow arrows). 

Note how intra and extracranial air appears as black as fat in the orbits or in the scalp (red arrows) on brain window. 

Case Discussion

This patient had recently had paranasal sinus surgery and must have developed a CSF fistula. She went on to have the site of communication identified and surgically repaired. 

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