Intracranial aerocele in facial injury

Aspects of intracranial aerocele are described and exemplified by two cases which presented to the Plastic Surgery Unit. Austin Hospital, Melbourne, as radiological findings incidental to facial injury. The first case illustrated the occasional problem of identifying the site of dural tear; a fracture could not be identified on X-ray film or at operation, and this can make subsequent dural repair more difficult. The second case was associated with florid clinical signs of facial fractures which were supported by X-ray findings. Both patients underwent surgery for the primary injury, and received prophylactic therapy with antibiotic agents because of the risk of meningitis associated with dural tears. In neither case did intracranial air persist beyond 14 days; therefore, dural repair was not performed. It is important to look for evidence of dural damage when dealing with facial injury either in the casualty or in the subsequent management of the patient.