Published: Wed, March 14, 2018
Medicine | By Douglas Stevenson

Pocket of air found where man's brain should've been

Pocket of air found where man's brain should've been

He noted his left arm and leg had also become weaker but his apparent fitness and lack of "confusion or facial weakness" led doctors to believe there was nothing obvious, aside from age, to explain his symptoms.

Brown hopes that his case report will encourage other physicians to fully investigate their patients, even if they present common symptoms, in order to help miss a rare cause or condition.

Brain-imaging CT scans revealed a odd 9-centimeter (3.5-inch) void in his skull just behind his forehead in the right frontal lobe. When the results from the CT scan came out, the doctors saw a 3-inch air pocket in his right frontal lobe.

"Immediately, I could see the abnormality and wondered if the patient had failed to tell us about a previous brain surgery in his younger years" or if the patient was born with a brain abnormality, Brown told Live Science.

The unnamed man sought medical attention after several months of unsteady walking, multiple falls and weakness on his left side.

Finlay Brown, a general practitioner in Belfast, first reviewed the brain scan while waiting to hear back from radiologists.

Generally, pneumocephalus appear after brain surgery, sinus infections or head and facial injuries. Basically, every time the patient sneezed or a cough, tiny air bubble would travel to his brain, thus creating a pressurized air pocket. The condition is when a pocket of pressurized air forms within the cranium, which typically happens after brain surgery, the study's authors said.

This had enabled a "one-way valve effect" that had gradually carved the cranial air cavity, he said.

"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 added.

The pneumocephalus, as discovered after the MRI, was caused by an osteoma, or a benign bone tumor that formed in the patient's sinuses and was eroding through the base of his skull.

Irish man had a 3.5-inch air pocket is his brain.

However, the man declined both, because of his age and other health factors.

But the patient said he had suffered none.

"From speaking to the specialists, it seems it has been progressing insidiously over months to years", Brown told the Washington Post.

"When the patient sniffed/sneezed/coughed he would most likely be pushing small amounts of air into his head", Dr Brown told the Post.

In addition to the alarming air pocket, the CT scan also disclosed that the man had a benign tumor in his skull. He was prescribed medication to prevent another stroke and instructions to monitor the feeling in his left side and after 12 weeks, he "remained well", according to the study.

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

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