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A Patient with Massive Pneumocephalus without Sign of Tension Pneumocephalus

Seyed Farshad Heidari

Background: Pneumocephalus is an injury that characterized by air entrance into the intracranial space. It may occur after head trauma, infection, tumor or it may be iatrogenic. According to the amount of air increases, this can cause neurological findings with a mass effect and this condition is called tension pneumocephalus.

Case report: In this study present a case of a 63 year old man presented to the emergency department by EMS because of head trauma. He was found to have loss of consciousness. Brain CT-scan revealed the typical Mount Fuji sign suggestive of massive pneumocephalus. The patient was transferred to the ICU and was managed conservatively without any decompressive surgery. On evaluation of 5 days later, he was alert and asymptomatic and control brain CT-scan has minimal pneumocephalus. Then, the patient was discharged from hospital.

Conclusion: Although massive pneumocephalus is a complication that if it is not treated immediately, it may be convert to tension pneumocephalus and give rise to serious morbidity and mortality concerns, but this case showed massive pneumocephalus without sign of tension pneumocephalus that conservative treatment was done successfully.