A rare case of pneumorrhachis accompanying spontaneous pneumomediastinum

Borém, Luciana Mendes Araújo; Stamoulis, Dimitrius Nikolaos Jaconi; Ramos, Ana Flávia Mundim

doi:10.1590/0100-3984.2015.0031

Cited by 8 publications

(5 citation statements)

References 6 publications

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“…10 The association between PR and SPM is not fully understood, especially when accompanied by asthma exacerbation. PR may occur directly (trauma), as when atmospheric air enters the epidural space, or indirectly (spontaneous), 11 as in the current case. Air that has gone into the pulmonary perivascular interstitium migrates along fascial planes and moves from the posterior mediastinum (or retropharyngeal space) to the epidural space of the cervical and thoracic spine through the neural foramina.…”

Section: Radiologic Discussionmentioning

confidence: 84%

A 17-Year-Old Male Subject With Chest Pain, Worsening Dyspnea, and a Rare Complication

Angi

Papa

Pillo

et al. 2020

Chest

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Clinical EvaluationA 17-year-old male subject with allergic asthma since childhood was transferred from a local hospital to our Department of Pediatrics with reports of chest pain preceded by 3 days of a dry cough and worsening dyspnea. In the last year, he had been controlling his asthma symptoms exclusively with salbutamol, several times a month. The patient had smoked marijuana and tobacco on the previous morning of admission. He denied neurologic complaint, air travel, trauma, or vomiting. On physical examination, the patient was nontoxic appearing but was short of breath and unable to speak in full sentences. He was afebrile with an initial heart rate of 134 beats/min, a respiratory rate of 35 breaths/min, and room air pulse oximetry of 90%. Blood analysis revealed no significant changes, except for a neutrophil count of 14.62 Â 10

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Section: Radiologic Discussionmentioning

confidence: 84%

A 17-Year-Old Male Subject With Chest Pain, Worsening Dyspnea, and a Rare Complication

Angi

Papa

Pillo

et al. 2020

Chest

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“…The findings are clinically significant because most previous reports involved young adults. We reviewed the relevant literature regarding cases involving children aged <15 years and retrieved 25 articles reporting 32 cases [3], [4], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29]. In total, 22 boys and 10 girls aged between 1 and 15 years (mean age: 9 years) were identified.…”

Section: Discussionmentioning

confidence: 99%

Pneumorrhachis in children: A report of two cases and review of the literature

Yaginuma

Watanabe

Saitō

et al. 2019

Radiology Case Reports

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Pneumorrhachis refers to the clinical presentation of air within the spinal canal, and it is rarely associated with pneumomediastinum, particularly in young children. Pneumorrhachis associated with pneumomediastinum is generally asymptomatic. Here we report 2 unusual cases involving very young children with pneumorrhachis secondary to pneumomediastinum and present a review of the relevant literature. Case 1 involved a 4-year-old girl who presented with wheezing, violent coughing, and dyspnea associated with bronchiolitis. Case 2 involved a 3-year-old boy who presented with wheezing, violent coughing, and dyspnea associated with interstitial pneumonia possibly caused by graft-versus-host disease with human herpesvirus 6 infection after allogeneic hematopoietic stem cell transplantation. In both cases, pneumorrhachis improved with oxygen inhalation therapy and treatment of the underlying disease. Pneumorrhachis is rarely associated with neurological problems; however, decompressive laminectomy may be indicated to relieve the air block. Because pneumorrhachis is rare in children and neurological sequelae may be difficult to identify, close clinical, and radiographic observations are necessary. Plain radiography is not sufficient, and computed tomography should be performed to rule out intraspinal air.

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“…Although Hamman's sign is highly suggestive of the condition, it is present in less than half of all cases ( 5 ) . The combination of Hamman's syndrome and pneumorrhachis is rare and is believed to be attributable to the passage of air through the posterior mediastinum to the neural foramina and epidural space ( 6 , 7 ) .…”

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confidence: 99%