Esophageal–subarachnoid fistula: A case of spontaneous tension pneumocephalus in the setting of esophageal cancer. Issue 6 (25th March 2014)

• Record Type: Journal Article
• Authors: Patel, Mihir R.; Idicula, Winslo; Carrau, Ricardo L.; Prevedello, Daniel M.; Irish, Jonathan
• Is Part Of: Head & neck. Volume 36:Issue 6(2014:Jun.)
• Page Start: E52
• Page End: E56
• Publication Date: 2014-03-25
• Subjects: Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.23459
• Languages: English
• ISSNs: 1043-3074

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="hed23459-sec-0001" sec-type="section"> <title>Background</title> <p>Pneumocephalus occurs as a result of traumatic or iatrogenic violation of the dura. Tension pneumocephalus, whereby air continues to accumulate with no mechanism for escape, can cause significant morbidity and mortality.</p> </sec> <sec id="hed23459-sec-0002" sec-type="section"> <title>Methods</title> <p>This case report reviews the underlying pathophysiology, clinical presentation, diagnosis, and management of tension pneumocephalus.</p> </sec> <sec id="hed23459-sec-0003" sec-type="section"> <title>Results</title> <p>We present the case of a 68‐year‐old man who presented to the Emergency Department with headache thought to be the result of a newfound intracranial mass. After admission, he became obtunded and was found to have tension pneumocephalus requiring emergent evacuation. A cervical esophagus carcinoma caused an esophageal‐subarachnoid fistula that resulted in tension pneumocephalus after a retching episode.</p> </sec> <sec id="hed23459-sec-0004" sec-type="section"> <title>Conclusion</title> <p>This case illustrates the importance of considering alternative sources of pneumocephalus in the absence of more typical differential diagnosis. © 2013 Wiley Periodicals, Inc. <italic>Head Neck</italic> 36: E52–E56, 2014</p> </sec> </abstract>