Spontaneous intraventricular pneumocephalus
Dowd et al., report on an elderly woman in whom a intraventricular spontaneous pneumocephalus occurred because of a congenital defect in the left tegmen tympani. Eustachian tube closure and middle ear exclusion were used to obliterate the fistulous connection. This case illustrates both an unusual cause and a unique treatment for spontaneous otogenic pneumocephalus 1).
A 84-year-old man presented with dysarthria and incontinence. Computed tomography revealed an intraventricular pneumocephalus, thinning in the petrous bone, fluid in the air cells, and cleft in temporal lobe. A right subtemporal extradural approach was taken to detect bone-/-dural defects, and a reconstruction was performed using a musculo-pericranial flap.
This is the first patient of an isolated spontaneous intraventricular pneumocephalus without any other site air involved. Surgical approaches to repair such bone and dura defects should be considered an appropriate option 2).