Extensive Pneumorrhachis After Spontaneous Pneumomediastinum

Area of Science:

• Medical Case Study
• Radiology
• Spinal Imaging

Background:

• Pneumorrhachis is defined as air within the spinal canal.
• Etiologies are typically traumatic or iatrogenic.
• Rarely, pneumorrhachis may be associated with spontaneous pneumomediastinum.

Observation:

• A young adult male presented with subcutaneous emphysema following a choking incident.
• Imaging revealed extensive pneumorrhachis with anterior spinal cord displacement.
• The patient remained asymptomatic and was closely monitored in the ICU.

Findings:

• The extensive pneumorrhachis was asymptomatic in this patient.
• Esophageal rupture was ruled out as the cause of pneumomediastinum.
• The patient recovered fully without residual symptoms after 1 month.

Implications:

• Spontaneous pneumomediastinum can be associated with intraspinal air (pneumorrhachis).
• Patients with pneumomediastinum and neurological symptoms warrant evaluation for pneumorrhachis.
• This case underscores the importance of considering pneumorrhachis in spontaneous pneumomediastinum, even without neurological deficits.