In the literature pneumatocele is mentioned rarely in relation with trauma of the temporal bone.In fractures of the temporal bone escape of air into the tissues may result when the fracture line passes through the air cells by the following routes: 1) Air may pass intracranially into the subdural space, the subarachnoid sulci, the cisternal or brain substance resulting in pneumocephalus as reported by Ruskin.'2) The air may pass between the aditis and the plates of the skull in young adults as reported by Eggston and Wolff. 2 3) Air may find its way into the extracranial tissues giving rise to surgical emphysema or pneumatocele.'The case reported is concerned with the mechanism of route three.
REPORT OF A CASEM. M., aged 48 years, male, complained of swelling on the left side of his head with discomfort on coughing, blowing nose and sneezing, requiring support with the palm of the hand.Three years previously he was thrown from a car. He fell on the sidewalk on his left side. He was unconscious for six hours. He was diagnosed as a case of concussion and was advised to rest for three weeks. After recovery he resumed work on the third day. He experienced no headache, vomiting, giddiness or tinnitus. He was told by his doctor that little blood came from his left ear.After one month, he felt with his hand a small painless swelling the size of a small bean behind the left auricle. On pressing it it would disappear to reappear after approximately a quarter of an hour. The primary swelling gradually increased in size.
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