Asymptomatic pneumocephalus after head trauma: case report

BMJ Case Rep. 2009:2009:bcr10.2008.1028. doi: 10.1136/bcr.10.2008.1028. Epub 2009 Mar 5.

Abstract

A 66-year-old man was brought in to our emergency department (ED) with head trauma and was diagnosed with frontal located pneumocephalus based on a cranial computed tomography (CT) scan. At the time of arrival, he was alert and his Glasgow Coma Score (GCS) was 15. A neurological examination revealed no deficit and during follow-up in the ED his GCS did not deteriorate. Cranial CT scan demonstrated nasal fracture. On maxillofacial CT examination, we detected a nasal bone fracture, air loss and fluid was seen in the maxillary and ethmoid sinuses. In our case, pneumocephalus is assumed to be the result of ethmoid bone fracture. Despite the large amount of air in the subdural area, our patient had no symptoms. He was admitted to the intensive care unit for close monitoring and was discharged from hospital without neurological deficit on the fifth day of follow-up.