Traumatic Pneumocephalus

Pneumocephalus is defined as an intracranial gas collection which can be localized in the epidural, subdural, subarachnoid, intraventricular or intraparenchymal spaces. Pneumocephalus has numerous causes, including barotrauma, neoplasms, and spinal anesthesia. However, the majority of pneumocephalus cases are traumatic or iatrogenic in nature. A review of 295 patients with pneumocephalus by Markham also indicated that trauma is the most common cause of pneumocephalus and accounts for 75% of cases. Similar research finds pneumocephalus occurring in 0.5 to 1.0% of head trauma. In such traumatic cases, air can gain access into the cranium through a fracture involving a paranasal sinus or the middle ear cavity or less frequently in association with a compound depressed fracture of the cranial vault.