Vol 55, No 3 (2021)
Review Article
Published online: 2021-02-05
Pneumocephalus as a rare complication: a systematic review plus clinical vignette
Abstract
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.
Keywords: pneumocephalusspontaneousnon-traumaticatraumatic
References
- Paiva WS, de Andrade AF, Figueiredo EG, et al. Effects of hyperbaric oxygenation therapy on symptomatic pneumocephalus. Ther Clin Risk Manag. 2014; 10: 769–773.
- JELSMA F, MOORE DF. Cranial aerocele. Am J Surg. 1954; 87(3): 437–451.
- Markham JW. The clinical features of pneumocephalus based upon a survey of 284 cases with report of 11 additional cases. Acta Neurochir (Wien). 1967; 16(1): 1–78.
- JELSMA F, MOORE DF. Cranial aerocele. Am J Surg. 1954; 87(3): 437–451.
- HOROWITZ M. Intracranial pneumatocele – an unusual complication following mastoid surgery. J Laryngol Otol. 1964; 78: 128–134.
- DANDY W. Pneumocephalus (intracranial pneumatocele or aerocele). Archives of Surgery. 1926; 12(5): 949.
- Maier W, Fradis M, Scheremet R. Spontaneous otogenic pneumocephalus. Ann Otol Rhinol Laryngol. 1996; 105(4): 300–302.
- Richards SD, Saeed SR, Laitt R, et al. Hypercellularity of the mastoid as a cause of spontaneous pneumocephalus. J Laryngol Otol. 2004; 118(6): 474–476.
- Singh A, Alvarez J. Spontaneous otogenic intracerebral pneumocephalus. West J Emerg Med. 2010; 11(1): 107.
- Voldřich R, Májovský M, Chovanec M, et al. First Case Report of Bilateral Spontaneous Otogenic Pneumocephalus. World Neurosurg. 2019; 125: 179–182.
- Hage P, Daou B, Jabbour P. Spontaneous otogenic pneumocephalus due to altitude changes: A case report and review of literature. Clin Neurol Neurosurg. 2015; 138: 162–164.
- Dowd GC, Molony TB, Voorhies RM. Spontaneous otogenic pneumocephalus. Case report and review of the literature. J Neurosurg. 1998; 89(6): 1036–1039.
- Wilkinson EP, Meyer TA, Rubinstein JT. Spontaneous otogenic pneumocephalus managed with the middle fossa approach. Acta Otolaryngol. 2007; 127(8): 892–896.
- Vallejo LA, Gil-Carcedo LM, Borrás JM, et al. Spontaneous pneumocephalus of an otogenic origin. Otolaryngol Head Neck Surg. 1999; 121(5): 662–665.
- Stewart M, Farrell C, Pelosi S. Spontaneous Otogenic Pneumocephalus: Reporting a Unique Site of Dehiscence. OTO Open. 2019; 3(1): 2473974X18821931.
- Krayenbühl N, Alkadhi H, Jung HH, et al. Spontaneous otogenic intracerebral pneumocephalus: case report and review of the literature. Eur Arch Otorhinolaryngol. 2005; 262(2): 135–138.
- Villa RA, Capdevila A. Images in clinical medicine. Spontaneous otogenic pneumocephalus. N Engl J Med. 2008; 358(12): e13.
- Roberts GA, Foy PM, Bolger C. Idiopathic spontaneous cerebrospinal fluid rhinorrhoea and pneumocephalus: case report and literature review. Br J Neurosurg. 1996; 10(5): 513–517.
- Tucker A, Miyake H, Tsuji M, et al. Spontaneous epidural pneumocephalus. Neurol Med Chir (Tokyo). 2008; 48(10): 474–478.
- Lefranc M, Peltier J, Demuynkc F, et al. Tension pneumocephalus and rhinorrhea revealing spontaneous cerebrospinal fluid fistula of the anterior cranial base. Neurochirurgie. 2009; 55(3): 340–344.
- Tedeschi E, Iaccarino C, Covelli EM, et al. MR-Cisternography with T2-Weighted Single-Shot Fast Spin Echo Sequence in the Diagnosis of a Spontaneous CSF Fistula of the Sphenoid Sinus Causing Massive Pneumocephalus. Neuroradiol J. 2009; 21(6): 795–799.
- Mirone G, Rotondo M, Scuotto A, et al. Spontaneous intraparenchymal tension pneumocephalus triggered by compulsive forceful nose blowing. Emerg Med J. 2009; 26(11): 837–838.
- Baba M, Tarar O, Syed A. A Rare Case of Spontaneous Pneumocephalus Associated with Nontraumatic Cerebrospinal Fluid Leak. Case Rep Neurol Med. 2016; 2016: 1828461.
- Park P, Chandler WF, Telian SA, et al. Spontaneous chronic epidural pneumocephalus resulting from hyperpneumatization of the cranium causing mass effect: case report. Neurosurgery. 1998; 42(6): 1384–1386.
- Kuo MY, Lien WC, Wang HP, et al. Nontraumatic tension pneumocephalus--a differential diagnosis of headache at the ED. Am J Emerg Med. 2005; 23(2): 235–236.
- Trawöger R, Strasser K, Ellemunter H, et al. Spontaneous pneumocephalus in a newborn infant with myelomeningocele and hydromyelia. Dev Med Child Neurol. 1994; 36(10): 924–927.
- Oedemis E, Aslan Y. Spontaneous pneumocephalus associated with open myelomeningocele. Indian Pediatrics. 2004; 41: 289–290.
- Kutty RK, Sreemathyamma SB, Sivanandapanicker JL, et al. Spontaneous Pneumocephalus Secondary to Leaking Myelomeningocele. J Pediatr Neurosci. 2018; 13(3): 329–330.
- Erol FS, Kaplan M. Spontaneous pneumocephalus presenting with apnea attacks in a newborn with open myelomeningocele. Pediatr Neurosurg. 2004; 40(6): 312–313.
- Garonzik IM, Samdani AF, Carson BS, et al. Pneumocephalus in a newborn with an open myelomeningocele. Pediatr Neurosurg. 2001; 35(6): 334.
- Kim HS, Kim SW, Kim SH. Spontaneous pneumocephalus caused by pneumococcal meningitis. J Korean Neurosurg Soc. 2013; 53(4): 249–251.
- Baig WW, Nagaraja MV, Varma M. Spontaneous cerebrospinal fluid rhinorrhea with pneumocephalus: an unusual manifestation of nasal tuberculosis. Korean J Intern Med. 2012; 27(3): 350–352.
- Redhu R, Shah A, Jadhav M, et al. Spontaneous tension pneumocephalus in a patient with subdural empyema. J Clin Neurosci. 2011; 18(8): 1123–1124.
- Lin JJ, Wu CT, Hsia SH, et al. Pneumocephalus: a rare presentation of Candida sphenoid sinusitis. Pediatr Neurol. 2009; 40(5): 398–400.
- Martin SE, Allen SD, Faught P, et al. A 2-year-old boy with hemolytic uremic syndrome and pneumocephalus. Brain Pathol. 2012; 22(1): 121–124.
- Candan S, Katelioğlu M, Ceylan S, et al. Otogenic brain abscess with pneumocephalus. Infection. 1990; 18(3): 191–192.
- Shenoi AN, Shane AL, Fortenberry JD, et al. Spontaneous pneumocephalus in vertically acquired, late-onset neonatal Citrobacter meningitis. J Pediatr. 2013; 163(6): 1791.
- Kuo CC, Wang JY, Chien JY, et al. Nontraumatic pneumocephalus due to nosocomial Enterobacter cloacae infection. Diagn Microbiol Infect Dis. 2010; 66(1): 108–110.
- Alvideo JN, Sood BG, Aranda JV, et al. Diffuse pneumocephalus in neonatal Citrobacter meningitis. Pediatrics. 2006; 118: 1576–1579.
- Kamide T, Nakada M, Hayashi Y, et al. Intraparenchymal pneumocephalus caused by ethmoid sinus osteoma. J Clin Neurosci. 2009; 16(11): 1487–1489.
- Lehmer LM, Kissel P, Ragsdale BD. Frontal sinus osteoma with osteoblastoma-like histology and associated intracranial pneumatocele. Head Neck Pathol. 2012; 6(3): 384–388.
- Kinsley S, Dougherty J. Tension pneumocephalus related to an epidermoid tumor of ethmoid sinus origin. Annals of Emergency Medicine. 1993; 22(2): 259–261.
- Machicado JD, Varghese JM, Orlander PR. Cabergoline-induced pneumocephalus in a medically treated macroprolactinoma. J Clin Endocrinol Metab. 2012; 97(10): 3412–3413.
- Wang HC, Hwang JC, Peng JP, et al. Tension pneumocephalus--a rare complication of radiotherapy: a case report. J Emerg Med. 2006; 31(4): 387–389.
- Qu X, Yang W, Han T, et al. Pneumocephalus after interventional therapy in esophageal cancer. Clin Neurol Neurosurg. 2010; 112(8): 707–709.
- Swaid SN, Windham TL, Morawetz RB. Pneumocephalus secondary to spontaneous bronchial-subarachnoid fistula. Neurosurgery. 1983; 13(1): 72–73.
- Holmes M, Martin L, Hanckel R. Spontaneous pneumocephalus secondary to sarcoma of the ethmoid. Ann Otol Rhinol Laryngol. 1957; 66(4): 1021–1028.
- Iacoangeli M, Di Rienzo A, Fianchini A, et al. Acute tension pneumocephalus secondary to whole spine pneumorrhachis as an unusual presentation of a colon cancer complicated by a transsacral cerebrospinal fluid leak. J Clin Neurosci. 2013; 20(3): 469–471.
- Patel MR, Idicula W, Carrau RL, et al. Esophageal-subarachnoid fistula: a case of spontaneous tension pneumocephalus in the setting of esophageal cancer. Head Neck. 2014; 36(6): E52–E56.
- Ghimire P, Shapey J, Bodi I, et al. Spontaneous tension pneumocephalus and pneumoventricle in ecchordosis physaliphora: case report of a rare presentation and review of the literature. Br J Neurosurg. 2020; 34(5): 537–542.
- Lynn AM, Stuntz JT, Ward BH. Pneumocephalus: an unusual presentation of a persistent neurenteric fistula. J Pediatr. 1978; 93(5): 818–820.
- Tran P, Reed EJM, Hahn F, et al. Incidence, radiographical features, and proposed mechanism for pneumocephalus from intravenous injection of air. West J Emerg Med. 2010; 11(2): 180–185.
- Laurent PE, Coulange M, Bartoli C, et al. Retrograde cerebral venous air embolism: a rare cause of intracranial gas. Diagn Interv Imaging. 2014; 95(11): 1113–1115.
- Syed ON, Weintraub D, DeLaPaz R, et al. Venous air emboli from intravenous catheterization: a report of iatrogenic intravascular pneumocephalus. J Clin Neurosci. 2009; 16(10): 1361–1362.
- Işıkay S. Spontaneous Pneumocephalus Secondary to Positive Ventilation in an Infant. Indian J Pediatr. 2019; 86(4): 390–391.
- Park CY, Kim KS. Spontaneous pneumocephalus associated with pneumocele of the frontal sinus. Cephalalgia. 2010; 30(11): 1400–1402.
- Barry C, Rahmani G, Bergin D. Pneumocephalus and Meningitis as Complications of Mastoiditis. Case Rep Radiol. 2019; 2019: 7876494.
- Eggerstedt M, Hong S, Eddelman DB, et al. Spontaneous Otogenic Pneumocephalus: Case Series and Update on Management. J Neurol Surg B Skull Base. 2019; 80(4): 424–430.
- Harth C, Peeters I, Van Hoe L, et al. Intrathecal gadolinium-enhanced MR-cisternography for the detection of a petrous bone defect in a patient with spontaneous intraventricular pneumocephalus. Acta Neurol Belg. 2020; 120(3): 695–698.
- Pollaers K, Kuthubutheen J. Spontaneous Otogenic Pneumocephalus due to Frequent Plane Travelling. Case Rep Otolaryngol. 2019; 2019: 8768506.
- Wu YH, Yeh IJ, Liu KT. Spontaneous pneumocephalus and subdural hemorrhage after sneezing. Am J Emerg Med. 2018; 36(10): 1928.e1–1928.e3.
- Young M, Putty M, Schaible K. Spontaneous Intraventricular Tension Pneumocephalus: Case Report and Review of the Literature. World Neurosurg. 2018; 114: 317–322.
- Arai N, Tabuse M, Nakamura A, et al. Spontaneous Intraventricular Pneumocephalus. J Craniofac Surg. 2017; 28(3): 738–740.
- Guleria V, Sharma A, Sharda C, et al. Pneumocephalus presenting as sudden thunderclap headache. Asian Journal of Neurosurgery. 2017; 12(4): 695.
- Wannemuehler TJ, Hubbell RD, Nelson RF. Tension Pneumocephalus Related to Spontaneous Skull Base Dehiscence in a Patient on BiPAP. Otol Neurotol. 2016; 37(9): e322–e324.
- Odani N, Kitazono H, Deshpande GA, et al. Severe Sepsis due to Otogenic Pneumococcal Meningitis with Pneumocephalus without Meningeal Symptoms. Intern Med. 2015; 54(13): 1661–1664.
- Ratre S, Yadav Y, Choudhary S, et al. Pneumocephalus in cerebellopontine angle and meningitis secondary to chronic otitis media in a child. J Neurosci Rural Pract. 2015; 6(3): 413–416.
- Ginat DT, Moonis G. Barotrauma-induced Pneumolabyrinth and Pneumocephalus Associated With Semicircular Canal Dehiscence. Otol Neurotol. 2016; 37(4): e176–e177.
- Pishbin E, Azarfardian N, Salarirad M, et al. Spontaneous Nontraumatic Pneumocephalus: A Case Report. Iran Red Crescent Med J. 2015; 17(7): e23920.
- Remenschneider A, Santos F. Pneumocephalus, hearing loss, and vertigo after airline flight in a patient with superior canal dehiscence. In reply. Otol Neurotol. 2015; 36(3): 561–562.
- Rabello FA, Massuda ET, Oliveira JA, et al. Otogenic spontaneous pneumocephalus: case report. Braz J Otorhinolaryngol. 2013; 79(5): 643.
- Tamura Y, Suzuki M, Yamamoto M, et al. Extensive pneumocephalus extending into the lateral ventricles from a brain abscess: an intracranial complication of cholesteatoma. J Laryngol Otol. 2013; 127(2): 192–195.
- Javan R, Duszak R, Eisenberg AD, et al. Spontaneous pneumocephalus after commercial air travel complicated by meningitis. Aviat Space Environ Med. 2011; 82(12): 1153–1156.
- Mohammed ElR, Profant M. Spontaneous otogenic pneumocephalus. Acta Otolaryngol. 2011; 131(6): 670–674.
- Zhao N, Wang DD, Huang X, et al. Spontaneous otogenic pneumocephalus presenting with occipital subcutaneous emphysema as primary symptom: could tension gas cause the destruction of cranial bones? J Neurosurg. 2011; 115(4): 679–683.
- Lee JS, Park YS, Kwon JT, et al. Spontaneous pneumocephalus associated with pneumosinus dilatans. J Korean Neurosurg Soc. 2010; 47(5): 395–398.
- Murugesan C, Powell M, Khayal HB. Sinus barotrauma leading to extradural muco-pneumocephalus. Br J Neurosurg. 2010; 24(1): 80–81.
- Abbati SG, Torino RR. Spontaneous intraparenchymal otogenic pneumocephalus: A case report and review of literature. Surg Neurol Int. 2012; 3: 32.
- Pennings RJE, Liauw L, Cremers CW. A spontaneous otogenic extradural pneumocephalus. Otol Neurotol. 2009; 30(6): 864.
- Hyam JA, Morgan L, Mendoza ND. Coma caused by spontaneous otogenic pneumocephalus. Clin Neurol Neurosurg. 2008; 110(1): 62–64.
- Mathai J, Ahammed S, Pushpakumari KP, et al. Pneumocephalus presenting as a complication of chronic otitis media - a case report. Indian J Otolaryngol Head Neck Surg. 2008; 60(4): 390–392.
- Bhattacharyya N, Friedlander RM. Images in clinical medicine. Pneumocephalus associated with pneumosinus dilatans frontalis. N Engl J Med. 2007; 357(11): 1136.
- Ciorba A, Berto A, Borgonzoni M, et al. Pneumocephalus and meningitis as a complication of acute otitis media: case report. Acta Otorhinolaryngol Ital. 2007; 27(2): 87–89.
- Jensen MB, Adams HP. Pneumocephalus after air travel. Neurology. 2004; 63(2): 400–401.
- Schrijver HM, Berendse HW. Pneumocephalus by Valsalva's maneuver. Neurology. 2003; 60(2): 345–346.
- Añorbe E, Aisa P, Saenz de Ormijana J. Spontaneous pneumatocele and pneumocephalus associated with mastoid hyperpneumatization. Eur J Radiol. 2000; 36(3): 158–160.
- Babl FE, Arnett AM, Barnett E, et al. Atraumatic pneumocephalus: a case report and review of the literature. Pediatr Emerg Care. 1999; 15(2): 106–109.
- Boninsegna E, Barillari M, De Rossi S, et al. Non-traumatic pneumocephalus caused by increased depth of olfactory fossa. Br J Oral Maxillofac Surg. 2019; 57(6): 587–589.
- Gaberel T, Ponte KF, Khouri S, et al. Arachnoid cyst associated to spontaneous CSF fistula and massive pneumocephalus. Acta Neurochir (Wien). 2012; 154(10): 1941–1942.
- Nash R, Wilson M, Adams M, et al. Spontaneous pneumocephalus presenting with alien limb phenomena. J Laryngol Otol. 2012; 126(7): 733–736.
- Hogg RP, Pillay H, Mitchell R, et al. Idiopathic CSF rhinorrhoea presenting with tension pneumocephalus and hemiparesis. J Laryngol Otol. 1998; 112(7): 654–656.
- Mirzai S, Rifai AO, Webb S, et al. Probable pneumocephalus in a user of natural remedies with newly diagnosed diabetes mellitus type 1. IDCases. 2019; 17: e00581.
- Saleem S, Anwar A, Aslam H, et al. Non-Traumatic Pneumocephalus and Sub-Dural Empyema as a Complication of Chronic Sinusitis. Cureus. 2019; 11(7): e5202.
- Sun X, Chiang GC. Pneumocephalus as a Rare Presentation of Acute Sinusitis with Intracranial Extension - Two Cases and a Review of Literature. J Clin Imaging Sci. 2019; 9: 26.
- Ansari AS, Dennis BB, Shah D, et al. An unusual case of infective pneumocephalus: case report of pneumocephalus exacerbated by continuous positive airway pressure. BMC Emerg Med. 2018; 18(1): 2.
- Kumari A, Agrawal SC. Neonatal meningitis complicating with pneumocephalus. J Neurosci Rural Pract. 2014; 5(1): 68–70.
- Srikumar T, Pabbathi S, Fernandez J, et al. Aspergillus Terreus Brain Abscess Complicated by Tension Pneumocephalus in a Patient with Angiosarcoma. Am J Case Rep. 2017; 18: 33–37.
- Lin K. Pneumocephalus in an advanced aged woman. Chinese Medical Journal. 2014; 127(23): 4157–4158.
- Ramakrishnan S, Krishnan P, Chandra P, et al. Pneumocephalus in mixed aerobic and anaerobic (Bacteroides fragilis) meningitis. Indian Journal of Pathology and Microbiology. 2014; 57(1): 160.
- Kosac Vd, Matta APC, Prado FM, et al. Tension pneumocephalus and rhinorrhea related to chronic sinusitis. Arq Neuropsiquiatr. 2013; 71(4): 269.
- Rota E, Sacchini D, Paolillo F, et al. Pneumocephalus as uncommon presentation of pneumococcal meningitis. Neurol India. 2013; 61(3): 314–315.
- Kaur S, Seth A, Narula MK. Pneumocephalus: a rare complication of meningitis. Indian J Pediatr. 2012; 79(11): 1537–1538.
- Bhogal P, Bhatnagar G, Manieson J, et al. An unusual case of pneumocephalus. BMJ Case Rep. 2011; 2011.
- Kumari A, Agrawal SC. Pneumocephalus consequent to staphylococcal pneumonia and meningitis. J Pediatr Neurosci. 2011; 6(1): 84–86.
- Oh KP, Lee YJ, Bae SC, et al. Intractable progressive pneumocephalus due to tuberculous meningoencephalitis. Neurology. 2011; 77(6): 600–601.
- Damergis JA, Chee K, Amitai A. Otogenic pneumococcal meningitis with pneumocephalus. J Emerg Med. 2010; 39(3): e109–e112.
- Aghaei Lasboo A, Walker MT, Hijaz TA. An unusual appearance of discitis due to gas-forming Escherichia coli with associated pneumocephalus. Spine (Phila Pa 1976). 2010; 35(7): E257–E259.
- Chung SJ, Wan-Teck L, Tham SC, et al. Osteoradionecrosis of the cervical spine complicated by pneumocephalus and meningitis in a nasopharyngeal cancer patient radically treated with radiotherapy 11 years ago. BMJ Case Rep. 2009; 2009.
- Hama-Amin AD, Gilhuis HJ, Portegies P. Teaching neuroimages: pneumocephalus due to bacterial meningitis. Neurology. 2009; 73(10): e53.
- Sreejith P, Vishad V, Pappachan JM, et al. Pneumocephalus as a complication of multidrug-resistant Klebsiella pneumoniae meningitis. Eur J Intern Med. 2008; 19(2): 140–142.
- Townend BS, Whyte S, Sturm JW. Cerebral abscess with pneumocephalus. Intern Med J. 2005; 35(7): 429.
- Parmar MS. Pneumocephalus associated with Bacteroides fragilis meningitis. J Postgrad Med. 2004; 50(4): 272–273.
- Pooboni SK, Mathur SK, Dux A, et al. Pneumocephalus in neonatal meningitis: diffuse, necrotizing meningo-encephalitis in Citrobacter meningitis presenting with pneumatosis oculi and pneumocephalus. Pediatr Crit Care Med. 2004; 5(4): 393–395.
- Sedaghatian MR, Ramachandran P, Rashid N. Diffuse pneumocephalus caused by neonatal Enterobacter cloacae meningitis. Arch Dis Child Fetal Neonatal Ed. 2004; 89(4): F324.
- Kassim Z, Aziz AA, Haque QM, et al. Isolation of Proteus mirabilis from severe neonatal sepsis and central nervous system infection with extensive pneumocephalus. Eur J Pediatr. 2003; 162(9): 644–645.
- Goyal M, Sharma R, Berry M. Diffuse pneumocephalus due to meningitis: CT findings. Pediatr Radiol. 1996; 26(4): 278–279.
- Randall JM, Hall K, Coulthard MG. Diffuse pneumocephalus due to Clostridium septicum cerebritis in haemolytic uraemic syndrome: CT demonstration. Neuroradiology. 1993; 35(3): 218–220.
- Finelli PF, Bergen R. Spontaneous pneumocephalus with meningitis: CT demonstration. J Comput Assist Tomogr. 1991; 15(3): 525–526.
- Holtby I. Comment on Otogenic brain abscess with pneumocephalus. Infection. 1991; 18(1): 8000.
- Klein MA, Kelly JK, Jacobs IG. Diffuse pneumocephalus from Clostridium perfringens meningitis: CT findings. AJNR Am J Neuroradiol. 1989; 10(2): 447.
- Iplikcioglu AC, Karabag H. Frontoethmoid Osteoma Causing Tension Pneumocephalus. J Neurosci Rural Pract. 2019; 10(3): 548–550.
- Elabd SS, Ahmad MM, Qetab SQ, et al. Cabergoline-Induced Pneumocephalus Following Treatment for Giant Invasive Macroprolactinoma Presenting With Spontaneous Cerebrospinal Fluid Rhinorrhea. Clin Med Insights Endocrinol Diabetes. 2018; 11: 1179551418758640.
- Albert A, Allbright R, Nichols T, et al. Pneumocephalus after the Treatment of an Inoperable Superior Sulcus Tumor with Chemoradiation. Case Rep Oncol Med. 2017; 2017: 3016517.
- Hackenbroch C, Kleinagel U, Hossfeld B. Tension Pneumocephalus Due to an Osteoma of the Frontal Sinus. Dtsch Arztebl Int. 2017; 114(31-32): 534.
- Umredkar AB, Disawal A, Anand A, et al. Frontal sinus osteoma with pneumocephalus: A rare cause of progressive hemiparesis. Indian J Radiol Imaging. 2017; 27(1): 46–48.
- Jimenez-Jimenez E, Martí SS, Villas MV. Tension pneumocephalus related to radiotherapy for nasopharyngeal carcinoma. Case Rep Oncol Med. 2014; 2014: 327380.
- Marchant B, Sheele JM. A novel cause of pneumocephalus. J Emerg Med. 2013; 44(6): e381–e383.
- Nanba K, Usui T, Nakakuki T, et al. Tension pneumocephalus after administration of two 0.25 mg cabergoline tablets in MEN1-related macroprolactinoma. BMJ Case Rep. 2013; 2013.
- Guedes Bd, da Rocha AJ, da Silva CJ, et al. A rare association of tension pneumocephalus and a large frontoethmoidal osteoma: imaging features and surgical treatment. J Craniofac Surg. 2011; 22(1): 212–213.
- Chung SJ, Wan-Teck L, Tham SC, et al. Osteoradionecrosis of the cervical spine complicated by pneumocephalus and meningitis in a nasopharyngeal cancer patient radically treated with radiotherapy 11 years ago. BMJ Case Rep. 2009; 2009.
- Torres A, Holoye PY, Camacho LH. Spontaneous pneumocephalus associated with recurrent colorectal carcinoma. J Clin Oncol. 2008; 26(33): 5483–5484.
- Bramley DC, Ghosh S. Tension pneumocephalus attributable to an ethmoid osteoma presenting as a stroke in evolution: an unusual presentation. Emerg Med J. 2001; 18(4): 317–318.
- Wu CT, Lee ST. Delayed spontaneous tension pneumocephalus caused by radionecrosis of the skull base. Br J Neurosurg. 1999; 13(2): 214–216.
- Jakubowski E, Kirsch E, Mindermann T, et al. Intradiploic epidermoid cyst of the frontal bone presenting with tension pneumocephalus. Acta Neurochir (Wien). 1997; 139(1): 86–87.
- Kiu MC, Wan YL, Ng SH, et al. Pneumocephalus due to nasopharyngeal carcinoma: case report. Neuroradiology. 1996; 38(1): 70–72.
- Ng WF, Fung KH, Sham JS. Tension pneumocephalus--a rare complication of radiotherapy in nasopharyngeal carcinoma. Pathology. 1995; 27(2): 204–208.
- Banerjee T, Meagher JN, Donley C. Osteoid osteoma of the ethmoid and pneumocephalus. South Med J. 1975; 68(1): 90–93.
- Wilson ES, Sheft DJ. Epidermoid tumor of the skull with intracranial pneumatocele. Case report. J Neurosurg. 1968; 28(6): 600–602.
- Akashi K, Saegusa J, Morinobu A. Pneumocephalus in granulomatosis with polyangiitis. Rheumatology (Oxford). 2016; 55(1): 108.
- Miyaji Y, Kurokawa T, Tanaka F, et al. Meningitis with pneumocephalus originating from a sacral pressure ulcer. Intern Med. 2013; 52(18): 2163–2164.
