Symptomatic intraspinal pneumocoele resulting from closed head injury

Abstract

Intraspinal pneumocoele is rarely associated with closed head injury. We describe a case of intra-spinal pneumocoele following a closed head injury. We believe this to be the first case presenting with radicular symptoms.

Pneumorachis of the cervical spine with associated pneumocephalus and subcutaneous emphysema

“…The phenomenon of intraspinal air has been described with various terms such as intraspinal pneumocoele, spinal epidural and subarachnoid pneumatosis, aerorachia, pnemosaccus or traumatic pneumomyelogram 1–59,. The term pneumorrhachis was first coined by Newbold et al .…”

“…Yousaf et al . reported a case of pneumorachis with associated radicular symptoms and treated him successfully with cervical collar and supplemental oxygen 9. The presence of traumatic subarachnoid pneumorachis implies an open injury with an accompanying 25% risk of meningitis 14.…”

“…If general anesthesia is required in such patients, the attending anesthetist should not use inhalational nitrous oxide as it causes an increase in the intracranial pressure after diffusing into the air-filled spaces 15. Few workers have used supplemental oxygen therapy to facilitate air absorption 29…”

Isolated subarachnoid pneumorrhachis

“…The general approach is conservative with meningitis prophylaxis unless there is neurologic deterioration. [8] Habibullah Dolgun, Bora Gurer, Onur Sari 1 , Zeki Sekerci …”

Pneumorrhachis: a rare complication of diabetic ketoacidosis

“…Other conditions, aside from DKA, in which pneumorrhachis has been reported include trauma, respiratory conditions (associated with high intrathoracic pressure and barotrauma), iatrogenic causes (e.g. manipulation during surgery or anaesthesia) or spontaneous occurrence [5].…”