BMJ Case Reports 2018; doi:10.1136/bcr-2017-222892
  • Unusual association of diseases/symptoms

The man that lost (part of) his mind

Editor's Choice
  1. Djamil Vahidassr2
  1. 1 General Practice, Northern Ireland Medical and Dental Training Agency, Belfast, UK
  2. 2 Care of The Elderly and Stroke, Antrim Area Hospital, Antrim, Co Antrim, UK
  1. Correspondence to Dr Finlay Brown, finlaybrown{at}
  • Accepted 6 February 2018
  • Published 27 February 2018


An 84-year-old man presented to the emergency department following recurrent falls over several weeks and onset of new left-sided weakness. CT of the brain revealed a large air cavity (pneumatocoele) in the right frontal lobe thought to be secondary to an ethmoidal osteoma communicating through the cribriform plate allowing air to be forced into the skull under pressure. Subsequent MRI confirmed these findings and also revealed a small focal area of acute infarction in the adjacent corpus callosum. The patient had a prolonged hospital stay, declined neurosurgical intervention and was discharged home on secondary stroke prevention.


  • Contributors FB was personally involved with the care of the patient described in this case report. FB discussed the case at length with DV (stroke specialist), who helped with the construct of this case report, reviewing several drafts including relevant radiological figures.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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