Traumatic epidural pneumorrhachis.

DESCRIPTION A 57-year-old man was admitted to the emergency department with blunt thoracic and abdominal trauma after being hit by a tree. CT of the thorax and abdomen was performed. Abdominal CT showed a large retroperitoneal haematoma secondary to an injury of celiac trunk; thoracic CT showed a right haemo-pneumothorax, a pneumomediastinum, a large basal lung contusion, a small dorsal right subcutaneous emphysema, the fractures of third, fourth and fifth right ribs (figure 1) and some small air bubbles in the spinal canal between the second and the fifth thoracic vertebra (figure 2). Pneumorrhachis (air within the spinal canal) is an extremely rare manifestation of severe trauma. Air within the spinal canal may occur in the epidural or subarachnoid space. The latter is frequently associatedwithmore serious injuries like skull fractures and thoracic spine fractures and is almost always associated with pneumocephalus. In skull fractures subarachnoid pneumorrhachis is the consequence of pneumocephalus, while in spine fractures