Pneumorrhachis in children: A report of two cases and review of the literature

Kazufumi Yaginuma, MD; Masahiro Watanabe, MD, PhD; Yasushi Saito, MD; Nobuhisa Takahashi, MD; Yoshihiro Ohara, MD, PhD; Shogo Kobayashi, MD, PhD; Kazuhiro Mochizuki, MD, PhD; Kazuhide Suyama, MD, PhD; Masatoki Sato, MD, PhD; Hideki Sano, MD, PhD; Koichi Hashimoto, MD, PhD; Atsushi Kikuta, MD, PhD; Mitsuaki Hosoya, MD, PhD

Radiology Case Reports (Nov 2019)

Pneumorrhachis in children: A report of two cases and review of the literature

Kazufumi Yaginuma, MD,
Masahiro Watanabe, MD, PhD,
Yasushi Saito, MD,
Nobuhisa Takahashi, MD,
Yoshihiro Ohara, MD, PhD,
Shogo Kobayashi, MD, PhD,
Kazuhiro Mochizuki, MD, PhD,
Kazuhide Suyama, MD, PhD,
Masatoki Sato, MD, PhD,
Hideki Sano, MD, PhD,
Koichi Hashimoto, MD, PhD,
Atsushi Kikuta, MD, PhD,
Mitsuaki Hosoya, MD, PhD

Affiliations

Kazufumi Yaginuma, MD: Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan; Corresponding author.
Masahiro Watanabe, MD, PhD: Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan
Yasushi Saito, MD: Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan
Nobuhisa Takahashi, MD: Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
Yoshihiro Ohara, MD, PhD: Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan
Shogo Kobayashi, MD, PhD: Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
Kazuhiro Mochizuki, MD, PhD: Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
Kazuhide Suyama, MD, PhD: Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan
Masatoki Sato, MD, PhD: Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan
Hideki Sano, MD, PhD: Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
Koichi Hashimoto, MD, PhD: Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan
Atsushi Kikuta, MD, PhD: Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
Mitsuaki Hosoya, MD, PhD: Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan

Journal volume & issue: Vol. 14, no. 11
pp. 1325 – 1329

Abstract

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Pneumorrhachis refers to the clinical presentation of air within the spinal canal, and it is rarely associated with pneumomediastinum, particularly in young children. Pneumorrhachis associated with pneumomediastinum is generally asymptomatic. Here we report 2 unusual cases involving very young children with pneumorrhachis secondary to pneumomediastinum and present a review of the relevant literature. Case 1 involved a 4-year-old girl who presented with wheezing, violent coughing, and dyspnea associated with bronchiolitis. Case 2 involved a 3-year-old boy who presented with wheezing, violent coughing, and dyspnea associated with interstitial pneumonia possibly caused by graft-versus-host disease with human herpesvirus 6 infection after allogeneic hematopoietic stem cell transplantation. In both cases, pneumorrhachis improved with oxygen inhalation therapy and treatment of the underlying disease. Pneumorrhachis is rarely associated with neurological problems; however, decompressive laminectomy may be indicated to relieve the air block. Because pneumorrhachis is rare in children and neurological sequelae may be difficult to identify, close clinical, and radiographic observations are necessary. Plain radiography is not sufficient, and computed tomography should be performed to rule out intraspinal air. Keywords: Pneumorrhachis, Pneumomediastinum, Children

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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