Pneumocephalus Secondary to a Neck Stab Wound without Neurologic Injury in a 13-Year-Old Girl

Abstract

Pneumocephalus is usually caused by injury that damages the brain meninges and thus allows air to enter the intracranial cavity. Our intention was to establish the importance of considering a stab wound in the neck as a possible cause of traumatic pneumocephalus. The paper presents the case of a 13-year-old girl who was accidentally stabbed in the neck with a kitchen knife by her brother. She had no neurological deficit but had developed headaches. An examination showed cerebrospinal fluid leaking from the neck wound and a CT scan revealed the pneumocephalus. Following surgical treatment, the patient’s clinical symptoms regressed. To our knowledge, this case is the first report of the manifestation of pneumocephalus as the result of a neck stab wound in a child; overall, there are only three reported cases of pneumocephalus caused by a neck stab wound.

Traumatic tension pneumocephalus – Two cases and comprehensive review of literature

“…[1] Its pathophysiology involves air entry into the cranial cavity following injury to the brain meninges. [2] Tension pneumocephalus (TP) is a clinical entity characterized by continued buildup of air within the cranial cavity, leading to abnormal pressure exerted on the brain and subsequent neurologic deterioration. [34] The accumulation of intracranial air can be acute or delayed.…”

An unusual case of cerebrospinal fluid leak and pneumocephalus following a lumbar stab injury

“…There have been four previous reports of cervical stabbings that have been complicated by pneumocephalus. 8,3,13,2 To our knowledge, this report is the first case of pneumocephalus following a traumatic lumbar back stabbing.…”

“…There have previously been four reported cases of pneumocephalus following stab wounds to the neck. 8,3,13,2 To our knowledge, this is the first case report of pneumocephalus secondary to a lower back stab wound.…”

“…However, two theories regarding its development have been postulated. 8,2,6 First, the punctured dura may act as a one way valve allowing the influx of air during pressure changes which occur, for example, during coughing or sneezing. The air then rises to collect within the cranial cavity.…”

“…It is believed that the latter hypothesis is the main cause of pneumocephalus developing secondary to stab wounds associated with dural injury. 2 Leakage of cerebrospinal fluid and the development of pneumocephalus are documented iatrogenic complications following lumbar puncture as well as epidural anaesthesia. 11,4,5 In these cases, the management is often conservative, although injection of autologous blood into the extradural space to create a blood patch and thus prevent further leakage of fluid is also practiced.…”