P N EU M O C EP H A LI

D EFIN ITIO N
Pneumocephalus, also known as (intra)

cranial aerocele may exist in a variety

of intracranial spaces, depending upon
the underlying cause.
Gas collection can occur in several
compartments: extradural, subdural
(most frequent), subcrachnoid,
intraventricular (pneumoventricle),
extradural and intracerebral
pneumatocoele.

ETH IO LO GY
Infection
HEAD TRAUMA
Barotrauma following scuba diving
surgery involving the sinuses, orbit,

nasal passages or intracranial space

Erosion from extracranial infections
or tumours.
Some cases are idiopathic

 The majority of cases are due to

either trauma (75-90%) or surgery

Only 0.5% to 1% of all episodes of
head trauma

 He presence of intracranial gas in a

patient with recent head trauma is a

sign suggestive of basal skull
fracture.

Mount fuji sign : subdura

Pathophysiology
Air being forced through the area of a

craniodural defect from coughing, sneezing

or other sudden changes in nasopharyngeal
pressure.
Excessive leak of cerebrospinal fluid (CSF)
causing a slightly negative intracranial
pressure.
Penetrating skull injuries
During lumbar puncture. This is referred to
as tension pneumocephalus and may
result in tonsillar herniation syndrome

Sign and sym ptom s

Headache
CSF rhinorrhoea or otorrhoea,
Seizure disorder and succussion-splash
Tympany on percussion of the skull
Papilloedema on fundoscopic
Confusion
Subtle weakness
Reflex abnormalities
gurgling sensation in the head

Treatm ent
usually gets absorbed without any clinical

manifestations
Placing the patient in the Fowler position of 30
Avoiding Valsalva maneuver (coughing and

sneezing)
Pand antipyretic medications to prevent
hyperthermia, and osmotic diuretics.
reabsorption was observed in 85% of cases

after 23 weeks