Otogenic pneumocephalus: case report and review of the literature.
We report a case of a 70 year old lady who presented to the accident and emergency department with a three day history of left sided otalgia, drowsiness and confusion. On admission her temperature was 39 degrees C, glascow coma scale was 14/15 and otoscopy revealed a left sided otitis media. There was no sign of CSF otorrhoea or mastoiditis. Neuro-otological examination was normal. High resolution CT scan of temporal bones and brain showed evidence of pneumocephalus near the left cerebello-pontine angle and posterior to the left petrous bone. No focal parenchymal pathology, intra-cranial bleed or defect in the tegmen was noted. The patient responded very well to conservative management in the form of high dose intravenous antibiotics. We would like to emphasise that this complication of otitis media should be borne in mind when an elderly patient presents with otalgia and confusion.
Glynn
F
F
Waterford Regional Hospital, Department of Otolaryngology Head and Neck Surgery, Dunmore road, Waterford, Ireland. fglynn@rcsi.ie
Skinner
L J
LJ
Daly
C A
CA
Donnelly
M
M
D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002444:Cefuroxime / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004433:Earache / Q000209:etiology; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D010033:Otitis Media / Q000150:complications* / Q000188:drug therapy; D038781:Otoscopy; D010406:Penicillins / Q000627:therapeutic use; D011007:Pneumocephalus / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed
D000890:Anti-Infective Agents; D010406:Penicillins; D002444:Cefuroxime