Spontaneous intraparenchymal otogenic pneumocephalus presenting with abrupt onset of coma. Issue 1 (February 2016)

• Record Type: Journal Article
• Authors: Scuotto, A.; Cappabianca, S.; Capasso, R.; Natale, M.; D'Oria, S.; Rotondo, M.
• Is Part Of: Radiography. Volume 22:Issue 1(2016)
• Page Start: e1
• Page End: e2
• Publication Date: 2016-02
• Subjects: Otogenic pneumocephalus -- Tensive pneumocephalus -- Mastoid hyperpneumatisation; Diagnostic imaging -- Periodicals; Radiotherapy -- Periodicals; Cancer -- Radiotherapy -- Periodicals; Diagnostic Imaging -- Periodicals; Neoplasms -- Periodicals; Radiotherapy -- Periodicals; Imagerie pour le diagnostic -- Périodiques; Radiothérapie -- Périodiques; Cancer -- Radiothérapie -- Périodiques; Electronic journals; 616.0757
• DOI: 10.1016/j.radi.2015.10.005
• Languages: English
• ISSNs: 1078-8174

Abstract

Abstract: We report a case of spontaneous otogenic pneumocephalus, manifesting with a rapid deterioration of consciousness level. A 37-year-old man presented a 3-days history of headache and fluctuant confusion. On admission the patient was neurologically intact except for temporo-spatial disorientation. Brain Computed Tomography (CT) scan showed a large air collection in the left temporal lobe, causing mass effect. Hyperpneumatisation of mastoid air cells was also noticed. Because of the abrupt onset of coma (Glasgow Coma Scale = 10), emergency surgical evacuation of tensive pneumocephalus was carried out. Postoperatively, the patient quickly regained a good level of consciousness and was headache-free. Highlights: Spontaneous otogenic pneumocephalus generally presents with subtle symptoms. Sudden consciousness involvement is a rare onset condition. Hyperpneumatisation of the petrous bone is a predisposing factor.