Extreme Calvarial and Upper Cervical Hyperpneumatization: A Case Report

Abstract

The pneumatization of bones of cranial base other than the mastoid process and temporal bone is a pathologic and rare condition, and it may cause some serious complications. Extension of the pneumatization to the cranial vault and upper cervical bones is extremely rare. A 67 year-old man was admitted with complaint of chronic nonspecific headache for a long time. He had no history of head trauma or otologic infection. Physical examination not revealed fever, any palpable swelling, rhinorrhea or otorrhea. There was only a slight right sensorineural hearing loss. Brain computerized tomography (CT) revealed hyperpneumatization in the right mastoid process and right temporal bone, bilateral occipital, parietal and frontal bones, and right side of the atlas. There was no pneumocephalus, but there was free air under the scalp of the right suboccipital region and around the right condyle, right transverse process of the atlas and right paravertebral region of the upper cervical vertebrae. Extrathecal cerebrospinal fluid (CSF) leakage was not detected by CT cisternography with intrathecal contrast administration and by the radionuclide cisternogram.

Keywords

• headache
• cerebrospinal fluid
• hyperpneumatization
• pneumatocele
• pneumocephalus