Craniocervical hyperpneumatization with concurrent pneumorrhachis, pneumomediastinum, and subcutaneous emphysema in a weightlifter

Craniocervical Pneumatization

“…Although there could be a genetic predisposition, CCP is an acquired process that can progress with time (5,18,19) and improve when treated (1,2,4,5,7,11,19,21). Pediatric case reports would be expected in the setting of a congenital anomaly and, in contrast, the youngest reported patients with CCP have been clustered in their 20s and 30s (1,(9)(10)(11)14,16,19,20).…”

“…To date, no treatment consensus exists for CCP. For patients with habitual VM, behavioral modification should be the first-line therapy (2,4,5,8,10). For noncompliant patients, refractory cases, or those lacking predisposing factors, PE tubes represent the least invasive treatment.…”

Traumatic Cervical Pneumorrhachis: A Case Report and Review of the Literature

“…In 2012, Ucler et al 16 reported a 56-year-old male patient with extensive cervical and thoracic pneumorrhachis after major multiple traumas with marked cerebrospinal fluid (CSF) leak and bilateral open depressed skull fractures. In 2013, Germino et al 5 reported pneumorrhachis in a patient who had craniocervical hyperpneumatization and claimed that, for a long time, the patient used to do the Valsalva maneuver. In 2015, Kara et al 9 reported 2 patients of traumatic pneumorrhachis and concluded that early diagnosis is important in the evaluation of the patients.…”

“…5,13 Most of the patients in the articles of pneumorrhachis were asymptomatic, while some case reports reported motor deficits and sensory deficits among those patients. 5 Pneumorrhachis is believed to be associated with increased mortality and morbidity as it is mostly associated with severe multiple trauma patients. Up till now, no specific guideline is present for treatment of pneumorrhachis.…”

Clinical Reasoning: Pneumocephalus and pneumorrhachis in a 67-year-old man

“…The gas arises when a negative pressure gradient exists across a breach in the skull, skull base, or dura mater. 1 Pneumocephalus has been reported after CNS trauma, 2 skull fractures, 3 neurosurgical procedures, 4 barotrauma, 5 extension of a pneumomediastinum caused by repetitive positive-pressure activities, 6 or an air embolus. 7 In the present case, there was no preceding trauma, and the patient had undergone no surgical or diagnostic procedure during the past year.…”