Traumatic Epidural Emphysema

Abstract

Epidural emphysema secondary to traumatic pneumomediastinum is benign and self-limiting. However, the life-threatening causes should be considered and ruled out.

High-pressure water injection to the neck

“…3 Neurological deficit has been reported after epidural anaesthesia where large volumes of air have been injected but we found no reports of neurological deficit following trauma and air in the epidural space. 3,4 Few cases of conservative management of these injuries have been reported but it was felt that the risks of surgical exploration outweighed those of conservative management given the site of injury.…”

A pain in the neck

“…The patient was diagnosed with a pneumomediastinum and the author notes that this diagnosis should be considered in athletes with retrosternal chest pain and that a slight amount of force is sufficient to sustain such an injury. Goh et al 3 described the case of a 22-year-old basketball player who, following a collision with another player, developed gradual onset chest and neck pain and was found to have surgical emphysema, pneumomediastinum and extradural air. This is a very similar precipitating event and clinical presentation to our patient, however, no air in the pleural space and no pneumopericardium was demonstrated in this case.…”

Pneumorrhachis, pneumomediastinum, pneumopericardium and subcutaneous emphysema as complications of bronchial asthma

“…[12] External PR is usually asymptomatic and often an accidental radiological finding, whereas internal traumatic PR is often associated with fatal outcomes. [4]…”