Vol 55, No 3 (2021)
Review Article
Published online: 2021-02-05

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Pneumocephalus as a rare complication: a systematic review plus clinical vignette

Katarzyna Śmiłowska1, Katarzyna Sznajder-Stacha2, Daniel Kocyłowski3, Aleksandra Popek4, Kamila Rozpondek2, Maciej Grechuta2, Mehri Salari5
Pubmed: 33543469
Neurol Neurochir Pol 2021;55(3):253-268.


Introduction. Pneumocephalus is a clinical entity characterised by the presence of gas in the intracranial space. It can result from many different causes. The most common cause is head or facial trauma. Other causes include neoplasms, infections, and surgical or diagnostic procedures. Spontaneous non-traumatic pneumocephalus is a rare condition caused by bone defects, malformations, infections, tumours, intravenous air injection, and other causes. This review, supplemented with a case presentation, aims to summarise the current state of knowledge regarding non-traumatic pneumocephalus.

Methodology. This review involved an electronic search (PubMed, Scopus, Embase, and Web of Science) to identify studies regarding non-traumatic pneumocephalus. In addition, reference lists of identified articles were screened for other potentially relevant papers.

Results. In total, 1,107 articles were retrieved by searching databases with the selected query. Based on the selection process, 134 articles were included. These articles were then classified into ‘otogenic’, ‘bone defect’, ‘malformations’, ‘infectious’, ‘tumours’, ‘associated with intravenous air injection’, and other categories.

Conclusion. Spontaneous non-traumatic pneumocephalus is a rare condition. Symptoms, clinical courses, and prognoses vary depending on the underlying cause of the disease. To the best of our knowledge, this review’s example is the first case report of spontaneous pneumocephalus due to air embolism secondary to lung cancer.

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