• Am J Emerg Med · Sep 2021

    Case Reports

    An unusual case of spontaneous nontraumatic pneumocephalus in the setting of remote craniofacial surgery.

    • Ryann Beaumont, Richard Anderson, and Jestin N Carlson.
    • Department of Emergency Medicine, Phoebe Putney Memorial Hospital, Phoebe Putney Health System, Albany, GA, United States of America. Electronic address: beaumontrr@gmail.com.
    • Am J Emerg Med. 2021 Sep 1; 47: 336.e1-336.e3.

    BackgroundPneumocephalus is an uncommon pathology that typically follows head trauma, neurosurgery, or skull base tumors. Rarely, cases of spontaneous pneumocephalus can occur, most often in the setting of barotrauma.Case DescriptionWe describe a rare case of spontaneous pneumocephalus in the absence of barotrauma in a 31-year-old male who presented with a headache and a normal neurologic exam. Imaging revealed subarachnoid and subdural pneumocephalus. The patient underwent surgical exploration, revealing an ethmoid bone defect caused by encroachment of material from a remote reconstructive surgery of the left orbit, which was subsequently repaired.ConclusionAlthough rare, spontaneous pneumocephalus should be considered even in the absence of clinical neurologic findings or barotrauma, in patients with previous cranial surgery and unexplained headaches.Copyright © 2021 Elsevier Inc. All rights reserved.

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