• T Hotta, Y Kodama, K Yuki, E Taniguchi, K Kuroki, A Hashizume, and T Uozumi.
• Department of Neurosurgery, Kure National Hospital, Hiroshima.
• No Shinkei Geka. 1994 Mar 1; 22 (3): 259-63.

AbstractTwo cases of traumatic intracerebral pneumocephalus, a rare complication of head trauma, are presented. Case 1: A 14-year-old boy had a strong concussion in his forehead due to a motorbike accident. Slightly obtunded on admission showing GCS 10, he became conscious in several days. Head CT performed after 17 days showed a round air image in the right frontal lobe which kept increasing in size thereafter. Bilateral frontal craniotomy was performed 31 days after the injury. A craniodural defect with a herniated brain was found in the superior wall of the posterior ethmoid sinus and repaired. Case 2: A 55-year-old man received a left forehead concussion when his motorbike ran into a car from behind. Although he had been conscious ever since admission, head CT after 15 days showed a round air image in the left frontal lobe. MRI demonstrated the air to be located in the cerebral parenchyma distinctly and the brain to have herniated into the frontal sinus. As the air showed a tendency to increase in volume and mild psychic and memory disturbances appeared, bilateral frontal craniotomy was performed 34 days after the injury. A craniodural defect with a herniated brain was detected in the posterior wall of the frontal sinus and repaired. These two patients showed a small amount of cerebrospinal fluid (CSF) rhinorrhea before the operation. Following the surgical repair, no recurrence of pneumocephalus and CSF rhinorrhea has been seen in either case. Intracerebral pneumocephalus secondary to closed head trauma was thought to have been due to herniation of contused brain into a craniodural defect.(ABSTRACT TRUNCATED AT 250 WORDS)

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