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A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
Published on: March 26, 2019
Traumatic cerebral venous air embolism associated with open skull fracture: Radiographic differentiation from
Masamichi Endo1, Satoru Sugiyama1
1Department of Neurosurgery, Higashimatsuyama Municipal Hospital, 2392 Matsuyama, Higashimatsuyama, Saitama 355-0005, Japan.
Abstract:
Cerebral venous air embolism (CVAE) is a rare condition associated with various etiologies, including trauma. While intracranial air is a recognized finding in clinical practice, the pathway of its entry is rarely documented. An 84-year-old male presented following a head trauma after a fall. Computed tomography (CT) imaging revealed an open parietal skull fracture without associated intracranial hemorrhage. It also demonstrated that intracranial air was strictly restricted to the superior sagittal and cavernous sinuses. Consequently, a CVAE was diagnosed based on the air distribution, ruling out pneumocephalus. The patient remained clinically stable and was discharged after a 5-day hospital stay. Careful evaluation of the distribution of intracranial air on CT may aid in distinguishing CVAE from pneumocephalus and support appropriate clinical decision-making.
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