title: Spontaneous epidural air entrapment.
abstract: BACKGROUND
  Epidural pneumorrhachis (EPR), an extension of pneumomediastinum, results from air that leaks from the mediastinum and accumulates in the epidural space of the spine. It is an uncommon, benign condition; most cases are asymptomatic, are recognized only on computed tomography scans, and require no treatment.
  
  
  METHODS
  We present a case of EPR, pneumomediastinum, pneumothorax, and subcutaneous emphysema in a young male who was managed conservatively with supportive care.
  
  
  CONCLUSIONS
  EPR is a rare yet benign condition that can be found incidentally while working up lung or spine pathology. Although radiography can define the presence of a pneumomediastinum and subcutaneous emphysema, the diagnosis of EPR can only be made using computed tomography. The management of EPR is usually conservative, and the focus should be on underlying disease.
authors.affiliation: Department of Hospital Medicine, Medicine Institute, Cleveland Clinic, Cleveland, OH.
authors.forename: Naseem
authors.initials: N
authors.lastname: Eisa
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA.
authors.forename: Hamzah
authors.initials: H
authors.lastname: Moh'd
authors.affiliation: Department of Pulmonary Diseases, Critical Care, and Environmental Medicine, Tulane University Health Sciences Center, New Orleans, LA.
authors.forename: Abdul Hamid
authors.initials: AH
authors.lastname: Alraiyes
authors.affiliation: Department of Hospital Medicine, Medicine Institute, Cleveland Clinic, Cleveland, OH ; Department of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH.
authors.forename: Khaldoon
authors.initials: K
authors.lastname: Shaheen
authors.affiliation: Department of Pulmonary Diseases, Critical Care, and Environmental Medicine, Tulane University Health Sciences Center, New Orleans, LA.
authors.forename: Fayez
authors.initials: F
authors.lastname: Kheir
keywords: Mediastinal emphysema; pneumorrhachis; pneumothorax; subcutaneous emphysema