Traumatic pneumocranium

Case contributed by Dr Tee Yu Jin

Presentation

Road traffic accident. A direct impact of his motorcycle into a lamp post. Sustained a laceration wound over the forehead.

Patient Data

Age: 20 years
Gender: Male
X-ray

Skull X ray

Skull radiograph demonstrates a right pneumocranium.

CT

CT skull

Right pneumocephalus along with fractures involving the right orbit, right lamina papyracea, ethmoid air cells, greater wing of the left sphenoid and both maxilla. No intracranial bleed identified.

Case Discussion

Plain radiographs have a limited role in evaluating skull fractures and are generally superseded by CT scans. Not only are CT scans sensitive to the detection fractures but also able to exquisitely characterize their extent.

A skull radiograph was performed but fails to reveal skull fractures. Fortunately, a pneumocranium was reported and a follow-up CT skull was warranted for further assessment. This reveals skull fractures which were not identified on the previous skull radiographs.

Pneumocranium encompasses gas in any of the intracranial compartments. The vast majority of cases are asymptomatic and are most commonly encountered following trauma or surgery.

 

Case courtesy of Dr. Yun Sii Ing, Head and Consultant Radiologist, Sungai Buloh Hospital, Malaysia.

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Case information

rID: 68954
Published: 25th Jun 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: University of Malaya

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