Pneumocephalus in a case of nasopharyngeal carcinoma

An extensive mass involving the skull base was found in a 49-year-old male patient with nasopharyngeal carcinoma. Deteriorating neurologic status developed 2 weeks after radiation to the nasopharynx with the initial dosage of 5480 cGy and boosted dosage of 3520 cGy. Computerized tomography revealed multiple foci of air occupying the subarachnoid space, and an air-fluid level was found in the lateral ventricle. Antibiotics and conservative treatments were administered to the patient and consciousness returned gradually. Unfortunately, he died of hypovolemic shock owing to massive bleeding from the nasopharynx 7 days later.