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Effective but uncommon treatment of a spontaneous otogenic epidural pneumocephalus
  1. Veit-Maria Hofmann1,
  2. Annett Pudszuhn1 and
  3. Stefan Markus Niehues2
  1. 1 Klinik für Klinik für Hals-, Nasen- und Ohrenheilkunde, Charité - Universitätsmedizin Berlin, Berlin, Germany
  2. 2 Klinik für Radiologie, Charité - Universitätsmedizin Berlin, Berlin, Germany
  1. Correspondence to Dr Stefan Markus Niehues, Stefan.Niehues{at}


We describe an uncommon treatment for epidural pneumocephalus and an effective but uncommon treatment option. Complete and permanent relief was achieved in a young patient using a tympanostomy tube to eliminate excessive positive air pressure in the mastoid bone that was the cause of spontaneous pneumocephalus. The patient showed no recurrence and absence of clinical symptoms at outpatient follow-up. Post-traumatic, infectious or spontaneous pneumocephalus may require an active, usually surgical approach. Treatment with a tympanostomy tube can be an alternative in suitable patients.

  • ear, nose and throat
  • radiology
  • headache (including migraines)
  • trauma CNS/PNS
  • neurosurgery

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  • Contributors V-MH: patient clinician, manuscript writing and editing, final proof. AP: patient clinician, manuscript writing, final proof. SMN: image selection and editing, manuscript writing and editing, final proof.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

  • Patient consent for publication Obtained.