Post-traumatic tension pneumocephalus and cystic angiomatosis of the skull: case report

Abstract Background Tension pneumocephalus is an increasing air trapped intracranially. Either spontaneous, post-traumatic or iatrogenic in origin. Cystic angiomatosis is a benign vascular hamartoma of the skeleton, when acquired it is either due to trauma or infection. This is the second report in...

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Autores principales:	Haythem H. Osman, Nazik E. Abdullah, Ghada S. Alhassan, Tarig A. Nafie, Murtada I. Abdellatief, Ali M. Abdelsatir, Khalid O. Elzein, Emad I. Ahmed
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Pneumocephalus Traumatic Tension Cystic angiomatosis Skull Otorhinolaryngology RF1-547
Acceso en línea:	https://doaj.org/article/f037c204d73b47c4ad86cb1a944d7ff9
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spelling	oai:doaj.org-article:f037c204d73b47c4ad86cb1a944d7ff92021-12-05T12:05:28ZPost-traumatic tension pneumocephalus and cystic angiomatosis of the skull: case report10.1186/s43163-021-00187-61012-55742090-8539https://doaj.org/article/f037c204d73b47c4ad86cb1a944d7ff92021-12-01T00:00:00Zhttps://doi.org/10.1186/s43163-021-00187-6https://doaj.org/toc/1012-5574https://doaj.org/toc/2090-8539Abstract Background Tension pneumocephalus is an increasing air trapped intracranially. Either spontaneous, post-traumatic or iatrogenic in origin. Cystic angiomatosis is a benign vascular hamartoma of the skeleton, when acquired it is either due to trauma or infection. This is the second report in English literature of post-traumatic delayed tension pneumocephalus with the development of cystic angiomatosis of the skull bone. Case presentation A 55-year-old gentlemen, presented with scalp swelling of 6-month duration with history of head trauma 2 years back. The swelling was increasing and associated with progressive walking difficulties and left hearing loss. CT scan and MRI revealed extradural pneumocephalus, parietal and occipital pneumatocele, and multiple lytic bony lesions, left mastoid hyperpneumatization with inner table defect communicating with the extradural space. Diagnosis of delayed extradural tension pneumocephalus was made. Surgical exploration revealed multiple bony defects of parietal, temporal and squamous part of left temporal bones, confirmed extradural pneumocephalus with intact dura. Repair of mastoid defect of (0.5 × 0.5 cm), excision of pneumatocele and removal of lytic bones were performed. Defective bone “cribriform-like” was identified at occipital and parietal regions centrally with a defect of nearly 7 × 7 cm. Future cranioplasty was considered after 6 months. Histology of bony chips and surrounding soft tissues is recognized as cystic angiomatosis. Conclusions The present case developed two very rare complications, following trivial head trauma; the first complication was delayed extradural tension pneumocephalus with pneumatocele which presented 2 years after trauma, the origin of air was from a defect of the inner table of the mastoid, the second complication was cystic angiomatosis of the skull bones. Both complications were managed surgically in one operative session as a combined neurosurgery and otolaryngology teams approach.Haythem H. OsmanNazik E. AbdullahGhada S. AlhassanTarig A. NafieMurtada I. AbdellatiefAli M. AbdelsatirKhalid O. ElzeinEmad I. AhmedSpringerOpenarticlePneumocephalusTraumaticTensionCystic angiomatosisSkullOtorhinolaryngologyRF1-547ENThe Egyptian Journal of Otolaryngology, Vol 37, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Pneumocephalus Traumatic Tension Cystic angiomatosis Skull Otorhinolaryngology RF1-547
spellingShingle	Pneumocephalus Traumatic Tension Cystic angiomatosis Skull Otorhinolaryngology RF1-547 Haythem H. Osman Nazik E. Abdullah Ghada S. Alhassan Tarig A. Nafie Murtada I. Abdellatief Ali M. Abdelsatir Khalid O. Elzein Emad I. Ahmed Post-traumatic tension pneumocephalus and cystic angiomatosis of the skull: case report
description	Abstract Background Tension pneumocephalus is an increasing air trapped intracranially. Either spontaneous, post-traumatic or iatrogenic in origin. Cystic angiomatosis is a benign vascular hamartoma of the skeleton, when acquired it is either due to trauma or infection. This is the second report in English literature of post-traumatic delayed tension pneumocephalus with the development of cystic angiomatosis of the skull bone. Case presentation A 55-year-old gentlemen, presented with scalp swelling of 6-month duration with history of head trauma 2 years back. The swelling was increasing and associated with progressive walking difficulties and left hearing loss. CT scan and MRI revealed extradural pneumocephalus, parietal and occipital pneumatocele, and multiple lytic bony lesions, left mastoid hyperpneumatization with inner table defect communicating with the extradural space. Diagnosis of delayed extradural tension pneumocephalus was made. Surgical exploration revealed multiple bony defects of parietal, temporal and squamous part of left temporal bones, confirmed extradural pneumocephalus with intact dura. Repair of mastoid defect of (0.5 × 0.5 cm), excision of pneumatocele and removal of lytic bones were performed. Defective bone “cribriform-like” was identified at occipital and parietal regions centrally with a defect of nearly 7 × 7 cm. Future cranioplasty was considered after 6 months. Histology of bony chips and surrounding soft tissues is recognized as cystic angiomatosis. Conclusions The present case developed two very rare complications, following trivial head trauma; the first complication was delayed extradural tension pneumocephalus with pneumatocele which presented 2 years after trauma, the origin of air was from a defect of the inner table of the mastoid, the second complication was cystic angiomatosis of the skull bones. Both complications were managed surgically in one operative session as a combined neurosurgery and otolaryngology teams approach.
format	article
author	Haythem H. Osman Nazik E. Abdullah Ghada S. Alhassan Tarig A. Nafie Murtada I. Abdellatief Ali M. Abdelsatir Khalid O. Elzein Emad I. Ahmed
author_facet	Haythem H. Osman Nazik E. Abdullah Ghada S. Alhassan Tarig A. Nafie Murtada I. Abdellatief Ali M. Abdelsatir Khalid O. Elzein Emad I. Ahmed
author_sort	Haythem H. Osman
title	Post-traumatic tension pneumocephalus and cystic angiomatosis of the skull: case report
title_short	Post-traumatic tension pneumocephalus and cystic angiomatosis of the skull: case report
title_full	Post-traumatic tension pneumocephalus and cystic angiomatosis of the skull: case report
title_fullStr	Post-traumatic tension pneumocephalus and cystic angiomatosis of the skull: case report
title_full_unstemmed	Post-traumatic tension pneumocephalus and cystic angiomatosis of the skull: case report
title_sort	post-traumatic tension pneumocephalus and cystic angiomatosis of the skull: case report
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/f037c204d73b47c4ad86cb1a944d7ff9
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Post-traumatic tension pneumocephalus and cystic angiomatosis of the skull: case report

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