Esophageal-subarachnoid fistula: a case of spontaneous tension pneumocephalus in the setting of esophageal cancer.
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.
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Related Subject Headings
- Treatment Outcome
- Subarachnoid Space
- Radiography
- Pneumocephalus
- Otorhinolaryngology
- Neoplasm Staging
- Male
- Hyperbaric Oxygenation
- Humans
- Headache
Citation
Published In
DOI
EISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Treatment Outcome
- Subarachnoid Space
- Radiography
- Pneumocephalus
- Otorhinolaryngology
- Neoplasm Staging
- Male
- Hyperbaric Oxygenation
- Humans
- Headache