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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Osteomata of the paranasal frontal and ethmoidal sinuses are benign, slow growing tumors generally asymptomatic. Complications due to orbital or intracranial development of the osteoma are rare and demand neurosurgical treatment. The authors report two cases. In the first a fronto-ethmoidal osteoma first caused exophtalmos and later ophtalmoplegia due to compression of the superior ophtalmic vein. In the second case the posterior development of an osteoma of the frontal sinus resulted in pneumocephalus with epileptic fits and headache and initially homolateral hemiparesis. In both cases CT Scan showed the extent of the osteoma and in the second case the gap in the wall of the sinus. Both osteomata were radically removed through frontal craniectomy. The literature is reviewed, 12 other cases of pneumocephalus due to posterior development of paranasal osteomata have been published during the last 50 years.
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PMID:[Orbital and intracranial complications of paranasal osteomata (author's transl)]. 54 97

One month after having a right upper lobectomy to remove a squamous cell carcinoma, a 43-year-old man presented with a 4-day history of postural headache, worsened by standing and relieved by lying. Skull films showed prominent ventricular pneumocephalus. Iophendylate myelography was unrewarding, but isotope cisternography revealed a CSF fistula at the T4 level, extending into the thoracic cavity. Thoracoplastic removal of the first four ribs successfully prevented air passage and the patient had a rapid uneventful recovery.
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PMID:Hypoliquorreic headache and pneumocephalus caused by thoraco-subarachnoid fistula. 56 15

A 60 year old woman presented with headaches and a destructive lesion in the sella turcica. She refused treatment but returned seven years later with a spontaneous pneumocephalus and dementia. A mucocele of the sphenoid sinus was discovered. Her symptoms resolved after removal of the mucocele and obliteration of the sphenoid sinus.
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PMID:Mucocele of the sphenoid sinus presenting as spontaneous pneumocephalus. 96 36

An 18-year-old Chinese man, suffering from head injury in a motorcycle accident, with right traumatic frontal intracerebral hemorrhage and frontal bone fractures, underwent emergency craniotomy with evacuation of hematoma at a local out-patient clinic and three months later, he suffered from CSF rhinorrhea. Headache, nausea and vomiting developed a week prior to admission. Tension pneumocephalus was diagnosed by computed tomography (CT) scan and plain skull X-ray. The fistula tract of the ethmoid sinus was investigated by radioisotope albumin (RISA) cisternography. The patient subsequently underwent emergency craniotomy for decompression. During the operation, we found that the intracerebral pneumatocele in the right frontal lobe communicated with the ipsilateral ethmoidal sinus, through which extracranial air ingressed and CSF egressed. This pneumatocele was unroofed and the fistula was temponaded by pericranial muscles and the Gelfomas sealed by tissue glue. Finally duraplasty was performed. Follow-up CT scan revealed that pneumocephalus subsided and the patient was cured of CSF rhinorrhea on discharge. As a surgical emergency, tension pneumocephalus can be successfully treated only by early diagnosis and early treatment.
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PMID:Traumatic tension pneumocephalus--intracerebral pneumatocele: a case report. 140 24

Non-traumatic otologic diseases are a rare cause of pneumocephalus. Among them, few reports have been described whereas it occurred following oto-surgery. We present a case report of pneumocephalus in a patient who presented with CSF-otorrhea, headache, disorientation, after recent mastoid radical surgery. The definite diagnosis was done by CT scan imaging. We realize a review of the literature about this subject, we describe the clinical and diagnostic features, its possible physiopathology, and its surgical management.
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PMID:[Pneumocephalus as a complication of mastoid surgery]. 141 57

This report describes iatrogenic pneumocephalus in an obstetrical patient following attempted epidural anaesthesia using the loss of resistance technique. On the fourth attempt at epidural injection, an apparent loss of resistance was identified and 5 ml air was injected. The patient complained immediately of severe bifrontal headache followed by emesis. The baby was eventually delivered by Caesarean section, with general anaesthesia and avoiding nitrous oxide. The patient's headache resolved within 24 hr without further sequelae.
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PMID:Pneumocephalus following attempted epidural anaesthesia. 191 63

Two cases of skullbase-penetrating injuries caused by umbrella tips are reported. Case 1: 24-year-old male. Admitted with disturbance of consciousness, left hemiparesis, nasal bleeding, and laceration of left lower eyelid because of having been stabbed by an umbrella tip. Pupils and fundi revealed no definite findings. Plain skull X-ray showed turbid ethmoid sinus and fracture of planum sphenoidale. Cranial CT showed right putaminal hematoma with intraventricular hemorrhage and pneumocephalus. Increased ICP necessitated surgery two days after the injury. Dural laceration of planum sphnoidale, laceration of left optic nerve, right rectal gyrus contusion and rebleeding from the right lenticulostriate branch were observed. Dural plasty and removal of hematoma with external decompression were carried out. He had a good postoperative course, but left visual loss and left hemiparesis remained. Case 2: 29-year-old male. Admitted with excoriation of his right nostril because of having been stabbed by an umbrella tip, severe headache, and nasal discharge. Oculomotor palsy was observed as well as CSF rhinorrhea and meningeal irritability. Plain skull X-ray showed niveau in sphenoidal sinus, pneumocephalus, and fracture of sella turcica. His complaint disappeared after conservative therapy. We reviewed the literature and found only 4 similar cases. The skullbase, because of its anatomical character, is likely to be penetrated in orbital and periorbital injury caused by umbrella tips. Cases which include disturbance of consciousness have a poor prognosis. We hope the fact that umbrella tips can easily become life-threatening objects will come to the attention of the general public so that similar cases may be avoided.
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PMID:[Skullbase-penetrating injuries caused by umbrella tips: case reports]. 218 93

Pneumocephalus occurs in 0.5 to 1.0% of head trauma, but may also occur after neurologic surgery, or as a result of eroding infection or neoplasm. The pathophysiology involves the presence of craniodural fistula allowing ingress of air. A ball-valve mechanism may allow air to enter but not exit the cranium, or CSF leak permits air entrance as fluid leaves the intracranial space. While a "succession splash" is considered diagnostic of pneumocephalus, most patients have nonspecific signs and symptoms such as headache. Therefore, a high index of suspicion in a patient with recent head trauma is necessary. The diagnosis is made radiographically by CT scan. This is generally performed to rule out intracranial hematoma or cerebral contusion in head trauma, but will reveal even very small quantities of air to the unsuspecting physician. Therapy is often noninvasive, allowing the craniodural defect to heal spontaneously. Selected situations require immediate operative repair of the fistula.
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PMID:Post-traumatic intracerebral pneumatocele: case report. 225 75

A 51-year-old man complained of a headache of 2-months duration. Computerized tomography revealed pneumocephalus and an osteoma at the confluence of the frontal and ethmoid sinuses on the right. Craniotomy confirmed an osteoma with a spur as the cause of the pneumocephalus.
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PMID:Pneumocephalus associated with a frontoethmoidal osteoma. 260 86

Spontaneous pneumocephalus secondary to neoplasia is a rare condition. It may present with headaches, rhinorrhoea, otorrhoea, or meningitis in various combinations. A case of unusual presentation, with several months delay in diagnosis, with remarkable postoperative improvement is reported and the literature reviewed.
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PMID:Chronic spontaneous tension pneumocephalus due to benign frontal sinus osteoma. 278 24


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