A rare presentation of headache and runny nose: A case of pneumocephalus

Elizabeth Moss,James Hooper,Nihal Abosaif

doi:10.5348/ijcri-2016130-cr-10718

Abstract

A rare presentation of headache and runny nose: A case of pneumocephalus

Highlights

Pneumocephalus is the presence of air or gas within the cranial cavity
She was referred to the acute medical unit as her blood pressure was 213/94 mmHg and a computed tomography scan of her head was booked to rule out subarachnoid haemorrhage (SAH)
This rare condition can be dangerous if changes to tension pneumocephalus or introduces infection through the skull base leading to severe meningitis

Summary

INTRODUCTION

Pneumocephalus is the presence of air or gas within the cranial cavity. It is usually associated with disruption of the skull; after head and facial trauma, tumors of the skull base, after neurology or otorhinolaryngology, and rarely, spontaneously. The patient was referred to neurosurgical and ENT team and was discussed in their multidisciplinary team meeting when a CT thorax, abdomen and pelvis was performed to rule out any disseminated malignancy or other bony lesions e.g., multiple myeloma or plasmacytoma Her CT scan was normal with no evidence of other types of malignancy. She continued on the intravenous antibiotics (®Cefuroxime 2 g intravenously twice per day and ®aciclovir 800 mg intravenously three times per day) for two weeks oral antibiotics (®Co-amoxiclav 625 mg three time per day) and was discharged home for another follow-up in six weeks’ time Her repeat CT scan of head showed resolution of her pneumocephalus except for a very small intraventricular lesion (Figure 3)

DISCUSSION

CONCLUSION