Spontaneous Intraventricular Tension Pneumocephalus: Case Report and Review of the Literature.

BACKGROUND: Intracranial pneumocephalus is a well-known clinical entity most frequently caused by trauma and intracranial surgery. A less frequent cause of intracranial pneumocephalus is spontaneous pneumocephalus. Spontaneous pneumocephalus can have an intraventricular extension, causing tension intraventricular pneumocephalus.

CASE DESCRIPTION: We present an exceptionally rare case of spontaneous otogenic intraventricular pneumocephalus in a 58-year-old female that resulted in a decline in mentation and neurologic deficit. The patient was subsequently treated with ventriculostomy and middle fossa craniotomy, with repair of a bony defect and dural closure.

CONCLUSIONS: This case demonstrates an unusual presentation of spontaneous intraventricular tension pneumocephalus necessitating ventriculostomy in addition to the traditional repair of a cerebrospinal fluid fistula.