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Doc find air pocket where part of man's brain should be

14 March 2018

Additionally, blood tests in the emergency department came back normal and he showed normal eye movement ranges, visual fields, speech, and swallowing.

"(We) were all very perplexed by the images we saw!"

When the patient first spoke with his doctors, he told them told that, in addition to his frequent falls, he felt weakness in his left arm and leg.

In fact they even wondered if the man had forgotten to disclose elements of his medical history.

The most common causes for pneumocephalus include a sinus infection or serious facial trauma.

In this case, the patient's pneumatocele - or pressurised air cavity - measured about 3.5 inches at its longest, according to the BMJ Case Reports article.

"To find a pocket of this size in an organized fashion was extremely uncommon, with very few documented cases found while I was researching for writing up the case report", Brown said.

As explained in a case report called "The man that lost (part of) his mind" in the journal BMJ Case Reports, the 84-year-old man turned up to the emergency room at Causeway Hospital in Northern Ireland after suffering from a weakness on the left side of his body and repeatedly falling over.

On closer inspection, the doctors found that the scans revealed the likely source of the problem: a benign bone tumor in his sinus that had eroded a tiny passageway through his skull.

"When the patient sniffed/sneezed/coughed he would most likely be pushing small amounts of air into his head", Dr Brown told the Post. However, due to the associated risks, the man declined the offer. Based on the small number of similar cases reported, the doctors speculated that the tumor had created a small opening that pushed air into the brain like a "one-way valve".

"The left-sided weakness was noted to have resolved on follow-up 12 weeks later and he remained well", the authors conclude in the published report.

Brown also said the condition is found in almost 100 per cent of cases after brain surgery.

Brown said air could have entered when the man sniffed, sneezed or coughed, each time making the air pocket larger.

Brown added that "unfortunately, as there are not many cases [of pneumocephalus] published, it is hard to know the exact prognosis".

So far, though, the man appears to be doing well, despite the cranial air pocket.

Brown said he had never seen a case of brain pneumatocele tied to symptoms of falling, and he made a decision to publish this case to emphasize "the importance of thorough investigation of even the most common of symptoms", Brown said.

"Because every now and then, there will be a rare [or] unknown causation of these that could be overlooked", he told LiveScience.

Doc find air pocket where part of man's brain should be