title: Tension pneumocranium in childhood trauma.
abstract: BACKGROUND
  To report a case of fatal tension pneumocephalus in a 9-year-old boy following a severe motor vehicle accident.
  
  
  METHODS
  A young boy with a serious closed head injury was resuscitated in the emergency room and underwent CT scan of the head and orbits.
  
  
  RESULTS
  The CT-scan revealed a fracture of the orbital roof with extensive bilateral pneumocephalus.
  
  
  CONCLUSIONS
  A high index of suspicion for tension pneumocephalus is required in patients with severe head injuries presenting with periorbital swelling and perioccular trauma. A prompt CT scan and neurosurgical intervention are indicated.
authors.affiliation: Trauma Unit, Department of Pediatric Surgery, Trauma Unit Red Cross War Memorial Children's Hospital, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
authors.forename: Hardeep Singh
authors.initials: HS
authors.lastname: Gill
authors.forename: Arjan Bastiaan
authors.initials: AB
authors.lastname: van As
mesh_terms: D000063:Accidents, Traffic; D002648:Child; D017809:Fatal Outcome; D005264:Femoral Fractures / Q000453:epidemiology; D016489:Head Injuries, Closed / Q000150:complications*; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D009917:Orbital Fractures / Q000000981:diagnostic imaging / Q000209:etiology; D011007:Pneumocephalus / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed