Spontaneous Epidural Pneumocephalus

Abstract

Spontaneous epidural pneumocephalus is a rare condition. The authors reported a 35-year-old male patient with tinnutus, dull headache, and swelling on his head. Patient had a history of head trauma and skull fracture from when he was 5 years old. Cranial computed tomography revealed increase in pneumatization of right mastoid air cells and large epidural air in temporoparietal region. Inner table of right temporal bone got thinner, causing communication of mastoid air cells with epidural space. Epidural air had septations and exerted mass effect on the right parietal lobe with minimal midline shift. Thinning of also right parietal bone caused extension of epidural air into the right parietal subcutaneous tissue and hence subcutaneous swelling. There was no obvious fracture line. Spontaneous epidural pneumocephalus is extremely rare condition that may cause severe complications. There are several etiologic factors. Head trauma can be the eliciting factor in the authors' patient. It is important to be familiar with its presentation and imaging findings to make early diagnosis and treatment.