Journal List > J Korean Soc Radiol > v.65(5) > 1087027

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Kwak, Lee, Cha, Kang, Cho, Han, Park, and Kim: Massive Subarachnoid Pneumocephalus due to Transorbital Intracranial Penetrating Injury: A Case Report
Neuroradiology
Case Report

Journal of the Korean Society of Radiology 2011; 65(5): 447-450.

Published online: 30 November 2011

DOI: https://doi.org/10.3348/jksr.2011.65.5.447

Massive Subarachnoid Pneumocephalus due to Transorbital Intracranial Penetrating Injury: A Case Report

Soon Hyuk Kwak, MD, Seung Young Lee, MD, Sang Hoon Cha, MD, Min Ho Kang, MD, Bum Sang Cho, MD, Gi Seok Han, MD, Kil Sun Park, MD, Sung Jin Kim, MD

Department of Radiology, College of Medicine, Chungbuk National University, Cheongju, Korea.

Corresponding author: Seung Young Lee, MD. Department of Radiology, College of Medicine, Chungbuk National University, 410 Seongbong-ro, Heungdeok-gu, Cheongju 361-763, Korea. Tel. 82-43-269-6472, Fax. 82-43-269-6479, lsyrad@chungbuk.ac.kr

Received 1 August 2011       Accepted 21 August 2011

Copyright © 2011 The Korean Society of Radiology

Abstract

A transorbital intracranial injury is a rare penetrating injury that can cause severe damage to orbital and cerebral structures. We report the case of a 53-year-old woman with massive subarachnoid pneumocephalus caused by a transorbital penetrating injury. She presented to our hospital with ocular pain after she accidently pierced her left eye with a steel wire while fixing a plant in a pot. A physical examination did not show any neurologic deficit. A brain CT showed a massive subarachnoid pneumocephalus with minimal intracranial hemorrhage and a 3D-reconstructed CT image showing a fracture at the pneumatized anterior clinoid process. A follow-up brain CT scan performed 10 days later revealed that the pneumocephalus and intracranial hemorrhage had completely resolved. The patient recovered without any complications.

Keywords: Pneumocephalus, Transorbital Penetration, Anterior Clinoid Process

Figures and Tables

Fig. 1

A 53-year-old woman with a transorbital penetrating injury.

A. Axial, coronal and sagittal brain CT images show massive disseminated subarachnoid pneumocephalus. Note the low attenuation air-bubbles in both lateral, 3rd and 4th ventricles.
B, C. Reformatted oblique axial and sagittal images of facial bone CT show the portal of penetration. Bone defect and fractured fragment at orbital roof (arrow) and anterior clinoid process (arrowhead) are indicated. Air bubbles are shown along the penetration site of orbital fat.
D. 3D reconstruction image shows fracture at left anterior clinoid process. Note the superiorly displaced fractured fragment (arrow).
E. On the follow up brain CT after 10 days, pneumocephalus was completely disappeared.
jksr-65-447-g001

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