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Post-traumatic tension pneumocephalus

Case contributed by Ali Nourian
Diagnosis almost certain

Presentation

Head trauma with loss of consciousness.

Patient Data

Age: 30 years
Gender: Male

Air occupies the subdural space between the tips of the frontal lobes (named as Mount Fuji sign), suggesting tension pneumocephalus.

Acute EDH is also noted at right middle cranial fossa, which was associated with a fracture of the right squamous of temporal bone which is extended to the wing of sphenoid bone. Fracture is also noted at left frontal bone.

Case Discussion

Tension pneumocephalus is a neurosurgical emergency that occurs when subdural air causes a mass-effect over the underlying brain parenchyma, often from a ball-valve mechanism with one-way entry of air into the subdural space.

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