“Post Traumatic Brain Abscess Mimicking as Pneumatocele”: An Uncommon Presentation

Abstract

Pneumatocele is a very rare complication that follows head injury. Pneumatocele can result due to a craniodural fistula, formed either after a fracture involving air sinuses, roof of middle ear, or depressed fracture of skull. Gas-containing brain abscess is a life-threatening condition, which requires immediate diagnosis and prompt therapeutic intervention. The predisposing factors include hematogenous spread, contiguous infection, and abnormal fistulous communication due to head injury. This is a rare case in which the patient had a history of head trauma due to road traffic accident with frontal contusion and small pneumocephalus, which was managed conservatively 2 years earlier followed by cerebrospinal fluid (CSF) rhinorrhea after 2 months, which was also managed by nonsurgical management. He presented with intractable seizures and features of raised intracranial pressure (ICP) with imaging suggestive of air-containing cavity in frontal region (pneumatocele). Intraoperatively, there was brain abscess with dural defect for which abscess was excised, and dural repair with exteriorization of frontal sinus was done.

Keywords

pneumatocele - brain abscess - rhinorrhea - craniodural fistula

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