Post-traumatic epidural tension pneumocephalus: a case report.

Area of Science:

• Neurosurgery
• Trauma Care
• Radiology

Background:

• Pneumocephalus, typically self-limiting after surgery or trauma, can rarely present as a life-threatening tension pneumocephalus.
• Tension pneumocephalus is a critical neurosurgical emergency requiring immediate recognition and management.

Observation:

• A 30-year-old male presented with rapid deterioration following blunt head trauma.
• Imaging revealed a large right temporoparietal epidural pneumocephalus with significant mass effect, likely due to a mastoid sinus defect.
• A co-existing mucocele was suspected as a contributing factor.

Findings:

• Emergency burr hole evacuation provided initial stabilization and led to full recovery.
• The case represents a rare instance of post-traumatic epidural tension pneumocephalus potentially linked to a pre-existing mucocele.
• While initial decompression was successful, further intervention was ultimately required.

Implications:

• This case underscores the importance of considering tension pneumocephalus in patients with head trauma and neurological decline.
• Prompt surgical decompression is crucial for managing this rare but dangerous condition.
• The association with a pre-existing mucocele presents a novel finding in the literature for post-traumatic tension pneumocephalus.