Esophageal-subarachnoid fistula: a case of spontaneous tension pneumocephalus in the setting of esophageal cancer.

Journal Article (Journal Article)

BACKGROUND: Pneumocephalus occurs as a result of traumatic or iatrogenic violation of the dura. Tension pneumocephalus, whereby air continues to accumulate with no mechanism for escape, can cause significant morbidity and mortality. METHODS: This case report reviews the underlying pathophysiology, clinical presentation, diagnosis, and management of tension pneumocephalus. RESULTS: We present the case of a 68-year-old man who presented to the Emergency Department with headache thought to be the result of a newfound intracranial mass. After admission, he became obtunded and was found to have tension pneumocephalus requiring emergent evacuation. A cervical esophagus carcinoma caused an esophageal-subarachnoid fistula that resulted in tension pneumocephalus after a retching episode. CONCLUSION: This case illustrates the importance of considering alternative sources of pneumocephalus in the absence of more typical differential diagnosis.

Full Text

Duke Authors

Cited Authors

  • Patel, MR; Idicula, W; Carrau, RL; Prevedello, DM

Published Date

  • June 2014

Published In

Volume / Issue

  • 36 / 6

Start / End Page

  • E52 - E56

PubMed ID

  • 24038386

Electronic International Standard Serial Number (EISSN)

  • 1097-0347

Digital Object Identifier (DOI)

  • 10.1002/hed.23459


  • eng

Conference Location

  • United States