A case of pneumocephalus without craniofacial bone fracture

초록

To report rare case of intracerebral pneumocephalus without the craniofacial bone fracture. This report reviews a structural air pathway through the intracranium and a possibility that pneumoventricle and pneumocephalus can be occurred in a situation despite of no bony skull fracture.The 68 years female patient was experienced in pedestrian traffic accident. Consciousness was mild drowsy without neurologic deficits. She was suffered dyspnea due to hemopneumothorax. Severe subcutaneous emphysema was seen in her neck, face and chest. Battle's or Raccoon eye sign were not noted. No rhinorrhea or hemotympanium were present. A computed tomography(CT) scan of the head revealed a extensive pneumocephalus and pneumoventricle, mainly located in anterior horn of lateral ventricle and subarachnoid space. The images of the facial bones & skull base can not reveal a fracture. The air shadow was shown through the ICA pathway, pharynx and base of skull at neck area in initial Chest X-ray and facial bone CT.