Closed Head Injury: How Air Reaches the Cranial Venous Sinus?

Abad Cherif El Asri

doi:10.4172/2165-7548.1000121

Abstract

Air in the intracranial vascular compartment is uncommon, with only few reported case in the literature. In the absence of surgery or open head trauma, the origin of air bubbles in the venous sinus is still debated. We report a case of patient admitted in emergency room few minutes after a severe closed head injury, and in whom, the cranial CT-scan demonstrated feature of air along the superior sagittal sinus. Mechanisms explaining how air reaches the venous compartment will be discussed.

Highlights

Air in the intracranial vascular compartment is uncommon, with only few reported case in the literature
Free air in the intracranial cavity can often be shown on CT after cranial trauma, barotrauma, tumors, infections, some surgical interventions, after craniotomy, craniofacial reconstruction, posterior fossa operations in the sitting position, some interventional procedures such as lumbar puncture and insertion of arterial or venous catheters, nitrous oxide anaesthesia, and congenital cranium defects [1]
Posttraumatic air embolism in the cerebral venous sinuses is a rare finding in closed injury [1,2,3,4,5]

Summary

Introduction

Air in the intracranial vascular compartment is uncommon, with only few reported case in the literature. In the intensive care unit, two 16-gauge peripheral intravenous catheters were inserted and the patient was intubated and artificially ventilated. A cranial CT scan, was performed immediately, and was revealed a left acute subdural haematoma with diffuse massive cerebral oedema and significant mass effect.

Results

Conclusion