Irish man finds huge air pocket in his skull

Leslie Hanson
March 14, 2018

An 84-year-old man in Northern Ireland complaining of frequent falls and weakness on the left side of his body discovered that it was due to a massive air pocket that had filled the bulk of a section of his brain.

Still, there were no red flags in the man's medical history. Instead of brain tissue, the doctors found a 9 cm (~3.5 inch) pressurized pocket of air where much of his right frontal lobe ought to be.

"There was no confusion, facial weakness, visual or speech disturbance", the doctors wrote. He was otherwise fit and well, independent with physical activities of daily living (PADLs) and lived at home with his wife and two sons.

The most common causes for pneumocephalus include a sinus infection or serious facial trauma.

Doctors told the man that they could perform brain surgery to release the air from the cavity, which would allow his brain to resume its normal shape, as well as a separate surgery to remove the osteoma.

"To find a pocket of this size in an organized fashion was extremely uncommon, with very few documented cases found while I was researching for writing up the case report", Brown said.

"From speaking to the specialists, it seems it has been progressing insidiously over months to years", Brown told the Washington Post. When doctors were told that neither of these scenarios applied to the patient, they were "left very curious as to the cause of these findings", Brown said. "When the patient sniffed/sneezed/coughed he would most likely be pushing small amounts of air into his head". Based on the small number of similar cases reported, the doctors speculated that the tumor had created a small opening that pushed air into the brain like a "one-way valve". Those types of cavities are typically found in patients who've had brain surgery or various types of infections. When the man added left-sided arm and leg weakness to the list of complaints, his doctor advised him to go to the emergency room, fearing a possible stroke.

"Unfortunately, as there are not many cases published, it is hard to know the exact prognosis", Brown said. His brain was still there, it had just been squished out of the way by the pocket of air. During a follow-up appointment 12 weeks after his hospital visit, the patient reportedly no longer felt weakness on his left side and "remained well", according to his case study.

Brown hopes that his case report will encourage other physicians to fully investigate their patients, even if they present common symptoms, in order to help miss a rare cause or condition. "Because every now and then, there will be a rare [or] unknown causation of these that could be overlooked", he said.

Other reports by Iphone Fresh

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