Abstract
Pneumatocele is a very rare complication that follows head injury. Pneumatocele can
result due to a craniodural fistula, formed either after a fracture involving air
sinuses, roof of middle ear, or depressed fracture of skull. Gas-containing brain
abscess is a life-threatening condition, which requires immediate diagnosis and prompt
therapeutic intervention. The predisposing factors include hematogenous spread, contiguous
infection, and abnormal fistulous communication due to head injury. This is a rare
case in which the patient had a history of head trauma due to road traffic accident
with frontal contusion and small pneumocephalus, which was managed conservatively
2 years earlier followed by cerebrospinal fluid (CSF) rhinorrhea after 2 months, which
was also managed by nonsurgical management. He presented with intractable seizures
and features of raised intracranial pressure (ICP) with imaging suggestive of air-containing
cavity in frontal region (pneumatocele). Intraoperatively, there was brain abscess
with dural defect for which abscess was excised, and dural repair with exteriorization
of frontal sinus was done.
Keywords
pneumatocele - brain abscess - rhinorrhea - craniodural fistula
