Spontaneous pneumocephalus after commercial air travel complicated by meningitis.
Aviat Space Environ Med
; 82(12): 1153-6, 2011 Dec.
Article
em En
| MEDLINE
| ID: mdl-22195398
ABSTRACT
BACKGROUND:
Pneumocephalus usually results from trauma, infection, neoplasm, or iatrogenic causes. Barotrauma-induced spontaneous pneumocephalus is extremely rare, usually seen in divers or occassionally with air travel. CASE REPORT We report a case of a 61-yr-old female presenting with confusion, fever, and respiratory failure one day after developing sudden nausea, vomiting, and headache during descent on a commercial airliner. Pneumocephalus and meningitis were present on admission. Sinus computed tomography (CT) showed pansinusitis and a tiny bone defect in the posterior wall of the right sphenoid sinus, through which a cisternogram later showed free communication with the prepontine cistern. An orbital CT 2 yr earlier after a fall showed the bone defect, with no other areas of abnormality or fracture. After repair of defects by otolaryngology and appropriate antibiotics, she did well and was eventually discharged.DISCUSSION:
Changes in aircraft cabin pressure likely resulted in rupture of dura and arachnoid layers beneath the pre-existing bony defect, predisposed by existing sinus disease. The pathophysiology, implications, and potential sources of spontaneous pneumocephalus, as well as risks of postcraniotomy and post-trauma air-travel, are discussed.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Limite:
Female
/
Humans
/
Middle aged
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article