title: Coma caused by spontaneous otogenic pneumocephalus.
abstract: We present the first case of spontaneous otogenic pneumocephalus presenting with a rapid deterioration in conscious level. This occurred in a 69-year-old woman who was subsequently treated with a subtemporal, extradural exploration and packing of the multiple defects in the mastoid air cells. The patient made a full neurological recovery within 10 weeks. Spontaneous otogenic pneumocephalus is a rare condition and was previously understood to present with subtle symptoms of headache, aphasia and cognitive deficits. This case, however, establishes how it can cause a rapid decline towards coma.
authors.affiliation: Department of Neurosurgery, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, United Kingdom. jhyam25@hotmail.com
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Hyam
authors.forename: Laleh
authors.initials: L
authors.lastname: Morgan
authors.forename: Nigel D
authors.initials: ND
authors.lastname: Mendoza
mesh_terms: D000368:Aged; D003128:Coma / Q000209:etiology*; D005260:Female; D006801:Humans; D008416:Mastoid; D011007:Pneumocephalus / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy