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What is a Pneumocephalus?

Mary McMahon
Updated May 17, 2024
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Pneumocephalus is a condition in which gas is present in the skull. There are a number of things which can cause this condition and it can be a neurological emergency in the case of tension pneumocephalus, in which air can get into the skull but has no outlet for release. Treatment may require the services of a neurosurgeon and the patient often has other neurological issues which may require some time in the hospital for inpatient treatment and monitoring.

In very rare cases, this condition happens spontaneously. More commonly, the condition occurs as a result of complications from surgery on the skull. Surgical procedures such as neurosurgery as well as facial surgery can both lead to the introduction of air into the skull. People who have experienced penetrating head trauma can also develop pneumocephalus and may also have a cerebrospinal fluid (CSF) leak. Scuba diving has also been linked with pneumocephalus in some patients.

Diagnosis of this condition can sometimes be complicated. The patient often presents with a headache, and may also have neurological symptoms related to pressure on the brain caused by the buildup of air. If a doctor determines that there is a genuine neurological problem and orders a medical imaging study of the brain and skull, air will be visible within the skull cavity and the shape of the brain may appear distorted.

Treatment options for pneumocephalus vary. In some cases, the condition resolves on its own with some watchful waiting. Other patients may be treated with bed rest on their backs and inhalation oxygen. These patients are usually monitored by skilled nursing staff who check for signs of emergent neurological complications. Surgery is also an option for some patients if their condition does not appear to be resolving in a timely fashion.

Neurological injuries are a cause for concern. Whenever someone experiences head trauma, it is advisable to receive an evaluation from a neurologist who can check for signs of damage to the brain and spinal cord. People who develop headaches after falls or blows to the head should be taken for medical treatment immediately if they have not already been seen by a doctor. It is also important to be alert to the symptoms of complications as described by a doctor so that a patient cleared to go home can be brought back into the hospital if she or he takes a turn for the worse.

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Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a WiseGeek researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments
By anon313700 — On Jan 13, 2013

I had sinus surgery in September 2012. The doctor said I could use my c pap machine. As a result of this, it caused pneumocephalus. I have headaches every day. I've been to three doctors. Please help!

By anon280735 — On Jul 19, 2012

You would never, ever, send a diver back down to treat the bends.

Nitrogen bubbles have come out of the blood due to decompression. Putting the person back at depth, for the duration of any conceivable air tank, would not be sufficient to let these bubbles redissolve. --Rescue Diver

By bythewell — On Jun 30, 2012

@irontoenail - I think the small amount probably applies to people who get this condition through scuba diving. I've never heard of it in the brain before, but divers who surface too fast will often experience bubbles of gas in their blood in a condition called decompression sickness (also known as "the bends").

The cure for this is to either send the diver back down to come up more slowly, or if this isn't possible, to put them into a hyperbaric chamber. I imagine the same might work for someone who experiences bubbles of air in their brain for that reason, although I'm only guessing.

By irontoenail — On Jun 29, 2012

@w0wpow3r - I think it would really depend on where the air was and how much there was. If there's only a little bit, then it might not do much or any damage at all. It's obviously not pleasant or safe for people to have their brain essentially squished into a smaller area, but intracranial pressure sometimes happens with blood after trauma as well and people can survive it.

In fact there's one guy who managed to survive almost 90% of his upper brain being destroyed over time and he still manages to function relatively normally. Of course, that's different from it being put under pressure but it shows the adaptability of the human brain.

So, if there's a lot of air in the right place, death could be instant, and if there is only a bit of air in the right place, you might not even notice it for years. To get any more specific about time I'd need a degree in neurosurgery and a specific patient in front of me, I think and I'd still only be guessing.

By w0wpow3r — On Jun 07, 2011

How long between the time air enters the skull and the time someone can die? It seems to me that the timeframe may be a key factor as to whether someone can live through pneumocephalus.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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