Post traumatic pneumorrhachis and pneumocephalus

Case contributed by Dr Fakhry Mahmoud Ebouda

Presentation

An adolescent male victim of alleged motor vehicle accident presented in the ER with GCS of 10. He has multiple trauma with leaking of CSF and blood from both ears.

Patient Data

Age: 19 years
Gender: Male

CT done for this adolescent polytraumatized patient showed: Lonigitudinal fractute of both petrous temporal bones more evident on th left involving the mastoid.Disrupting fracture of the sphenoid bone with haemosinus of the sphenoids and ethmoids.Consequent pneumocephalus and pneumorrhachis.

Attenuated cerebral ventricles and basal cisterns with no mid line shift. Left posterior parietal area of cerebral contusion.

Partial antrior wedging of D12 vertebra with fracture of the right T. process of L3.

Right sided pneumothorax with underlying pulmonary collpase. Right basal and posterior pulmonary contsusion.Comminuted fracture of the right scapula.Right hepatic lobe injury.

Follow up by CT two days later showed: Abscence of  pneumocephalus and pneumorrhachis.

 

Modality: X-ray

Follow up chest XR after the patient admitted to ICU showing: endotracheal tube, chest tube and CVL.

Case Discussion

Pneumorrhachis or intraspinal air (air may present within the epidural or subarachnoid space) is quite rare. Hence the terminology epidural pneumatosis.

Our case is post traumatic pneumorachis and pneumocephalus. On follow up CT two days later, it resolved spontaneously.  

The case is courtesy of Dr Nabeeh Bajunaid, Neurosurgeon Consultant, RCMC.

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Case Information

rID: 26545
Case created: 27th Dec 2013
Last edited: 26th Nov 2015
Inclusion in quiz mode: Included

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