Patel MR, Idicula W, Carrau RL, Prevedello DM. Esophageal-subarachnoid fistula: a case of spontaneous tension pneumocephalus in the setting of esophageal cancer.
Head Neck 2013;
36:E52-6. [PMID:
24038386 DOI:
10.1002/hed.23459]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 08/13/2013] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND
Pneumocephalus occurs as a result of traumatic or iatrogenic violation of the dura. Tension pneumocephalus, whereby air continues to accumulate with no mechanism for escape, can cause significant morbidity and mortality.
METHODS
This case report reviews the underlying pathophysiology, clinical presentation, diagnosis, and management of tension pneumocephalus.
RESULTS
We present the case of a 68-year-old man who presented to the Emergency Department with headache thought to be the result of a newfound intracranial mass. After admission, he became obtunded and was found to have tension pneumocephalus requiring emergent evacuation. A cervical esophagus carcinoma caused an esophageal-subarachnoid fistula that resulted in tension pneumocephalus after a retching episode.
CONCLUSION
This case illustrates the importance of considering alternative sources of pneumocephalus in the absence of more typical differential diagnosis.
Collapse