Pneumocephalus resulting from traumatic pneumothorax and brachial plexus avulsion

Abstract

Abstract Background Traumatic pneumocephalus is commonly encountered after basal skull fractures and rarely associated with blunt chest trauma. Here, we report a case of pneumocephalus caused by traumatic pneumothorax and brachial plexus avulsion. Case Presentation A 20‐year‐old male was admitted to our hospital following a motorcycle accident with complete paralysis of the right upper limb. 2 days later, follow‐up computed tomography revealed a slight right pneumothorax, pneumomediastinum around the neck, and intracranial air without skull fracture. Air migrates into the subarachnoid space through a dural tear caused by a brachial plexus avulsion. The pneumocephalus immediately improved after the insertion of a chest drain. Conclusion Pneumothorax combined with brachial plexus avulsion could lead to pneumocephalus. Immediate chest drainage might be the best way to stop the migration of air; however, care should be taken to not worsen cerebrospinal fluid leakage.

Keywords

• blunt chest trauma
• brachial plexus avulsion
• cerebrospinal fluid leakage
• pneumocephalus
• pneumothorax