Spontaneous otogenic intracerebral pneumocephalus: case report and review of the literature.
Pneumocephalus is commonly associated with head and facial trauma, ear infection or surgical interventions. We describe the rare case of a spontaneous pneumocephalus arising from lateral mastoid air cells. A 48-year-old man presented with a 10-day history of sudden, repetitive, 'hammering-like' acoustic sensations in his left ear that were followed by word-finding difficulties and loss of vision in the right visual field. Imaging revealed a large, left temporal pneumatocele associated with a small acute intracerebral hemorrhage. Left temporal and subtemporal craniotomy and decompression were performed. Further exploration confirmed a dural and osseous defect in the anterolateral surface of the mastoid that was consecutively closed watertight. Although extremely rare, a spontaneous pneumocephalus with mastoidal origin should be considered as a possible diagnosis in patients with suggestive acoustic phenomena and other non-specific neurological symptoms.
Department of Neurology, University Hospital Zurich, 8091, Zurich, Switzerland.
Niklaus
N
Krayenbühl
Hatem
H
Alkadhi
Hans-Heinrich
HH
Jung
Yasuhiro
Y
Yonekawa
D001037:Aphasia / Q000209:etiology; D003399:Craniotomy; D019299:Decompression, Surgical; D004427:Ear Diseases / Q000150:complications*; D006801:Humans; D008297:Male; D008416:Mastoid / Q000166:cytology*; D008875:Middle Aged; D011007:Pneumocephalus / Q000209:etiology* / Q000601:surgery; D013701:Temporal Bone / Q000601:surgery; D013702:Temporal Lobe / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014786:Vision Disorders / Q000209:etiology