• Shah Sweni, Subramanian Senthilkumaran, Namasivayam Balamurugan, and Ponniah Thirumalaikolundusubramanian.
• Department of Emergency Medicine, Sri Gokulam Hospitals and Research Institute, Salem, Tamil Nadu, India, sweni85@gmail.com.
• Emerg Radiol. 2013 Dec 1; 20 (6): 573-8.

AbstractTension Pneumocephalus (PC) was described 50 years ago. A case of pneumocephalus (PC) following cervical epidural injection in a 50-year-old male worsened by air travel and manifested as tension pneumocephalus, confirmed by advanced neuroimaging, is reported for the first time along with literature review. The patient underwent emergent frontal burr hole evacuation and air gushed under pressure. The patient recovered well and is stable during a follow-up of 12 months. Presenting features and clinical course along with Mount Fuji sign, Peaking sign, and air bubble sign observed in this case are described. Also, the importance of considering neurosurgical and spinal procedures leading to PC have to be considered by practitioners before issuing fitness certificate before air travel, as PC is likely to get transformed to tension PC and can cause an in-flight emergency.

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