Pneumocephalus is a condition in which gas is present in the skull. There are a number of things which can cause this condition and it can be a neurological emergency in the case of tension pneumocephalus, in which air can get into the skull but has no outlet for release. Treatment may require the services of a neurosurgeon and the patient often has other neurological issues which may require some time in the hospital for inpatient treatment and monitoring.
In very rare cases, this condition happens spontaneously. More commonly, the condition occurs as a result of complications from surgery on the skull. Surgical procedures such as neurosurgery as well as facial surgery can both lead to the introduction of air into the skull. People who have experienced penetrating head trauma can also develop pneumocephalus and may also have a cerebrospinal fluid (CSF) leak. Scuba diving has also been linked with pneumocephalus in some patients.
Diagnosis of this condition can sometimes be complicated. The patient often presents with a headache, and may also have neurological symptoms related to pressure on the brain caused by the buildup of air. If a doctor determines that there is a genuine neurological problem and orders a medical imaging study of the brain and skull, air will be visible within the skull cavity and the shape of the brain may appear distorted.
Treatment options for pneumocephalus vary. In some cases, the condition resolves on its own with some watchful waiting. Other patients may be treated with bed rest on their backs and inhalation oxygen. These patients are usually monitored by skilled nursing staff who check for signs of emergent neurological complications. Surgery is also an option for some patients if their condition does not appear to be resolving in a timely fashion.
Neurological injuries are a cause for concern. Whenever someone experiences head trauma, it is advisable to receive an evaluation from a neurologist who can check for signs of damage to the brain and spinal cord. People who develop headaches after falls or blows to the head should be taken for medical treatment immediately if they have not already been seen by a doctor. It is also important to be alert to the symptoms of complications as described by a doctor so that a patient cleared to go home can be brought back into the hospital if she or he takes a turn for the worse.
