Progressive calvarial and upper cervical pneumatization associated with habitual valsalva maneuver in a 70-year-old man.
A 70-year old man with a 15-year-history of chronic daily Valsalva maneuvers for left ear congestion presented with worsening vertigo and calvarial (occipitoparietal) and upper cervical hyperpneumatization. With continued frequent Valsalva maneuvers, subsequent studies demonstrated increased pneumatization with extension of air into the epidural space, causing mass effect on the left parietal lobe. Four months after discontinuing the habitual Valsalva maneuvers, CT demonstrated resorption of the epidural air and partial regression of the calvarial pneumatization.
Littrell
Laurel A
LA
Department of Diagnostic Radiology, Mayo Clinic/Mayo Foundation, 200 First Street SW, Rochester, MN 55905, USA.
Leutmer
Patrick H
PH
Lane
John I
JI
Driscoll
Colin L W
CL
D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology; D003131:Combined Modality Therapy; D018450:Disease Progression; D004824:Epidural Space; D005064:Eustachian Tube / Q000503:physiopathology; D006184:Habits; D006801:Humans; D008297:Male; D009777:Occipital Bone / Q000000981:diagnostic imaging / Q000473:pathology; D010294:Parietal Bone / Q000000981:diagnostic imaging / Q000473:pathology; D010579:Petrous Bone / Q000000981:diagnostic imaging / Q000473:pathology; D011007:Pneumocephalus / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D011859:Radiography; D012886:Skull / Q000000981:diagnostic imaging* / Q000473:pathology; D018058:Tympanic Membrane Perforation / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D014636:Valsalva Maneuver / Q000502:physiology*