19 Harley St, London, W1G 9QJ, UK

Massive pneumorrhachis, pneumocephalus and pneumoopticus following thoracic trauma and avulsion of the brachial plexus: case report and review of the literature

A 41-year-old man with injury of right half of the thorax, fractures of the left crural bones and paralysis of the right upper limb was admitted to our hospital. A CT examination at admission revealed bilateral pulmonary contusion and bilateral fluid- and pneumothorax. In addition pneumomediastinum, pneumopericardium, subcutaneous emphysema and pneumorrhachis at the cervicothoracic transition was demonstrated. Abnormal findings in the skull and brain were not revealed. The fifth day after admission repeated CT examination demonstrated extensive frontal pneumocephalus on the right, presence of air in several cisterns and in the right optic nerve sheaths (pneumoopticus). Right frontal craniotomy was performed, dura mater was incised and air was evacuated. Rapid regression of pneomocephalus was evident postoperatively. The tenth day after admission MRI of the cervical spine and brachial plexus was performed. At the level of the C7 and C8, nerve roots pneumomenigocele and a nerve retracting ball indicating the presence of a nerve root injury were discernible. This case demonstrated that severe thoracic blunt trauma leads to acute increase of intrathoracic pressure with concomitant fluid- and pneumothorax, pneumomediastinum and pneumopericard. From the mediastinum air propagated subcutaneously. Disrupted cervical dural sheaths resulted in leakage of cerebrospinal fluid and entry of air from mediastinum to subdural and subarachnoid spinal and cranial space and to the subarachnoid space of the optic nerve

Keywords : Adult,Air,Brachial Plexus,complications,diagnostic imaging,etiology,Humans,injuries,Male,Optic Nerve Diseases,Paralysis,Pneumocephalus,Pneumothorax,Pressure,Spinal Canal,Spinal Diseases,Spine,Subarachnoid Space,Thoracic Injuries,Tomography,X-Ray Computed,, Pneumorrhachis,Pneumocephalus,Pneumoopticus,Following, piriformis syndrome groin pain

Date of Publication : 2011

Authors : Derner M;Drugova B;Horejsi L;Skvara D;Druga R;

Organisation : Department of Radiology, Masaryk Hospital in Usti nad Labem, Usti nad Labem, Czech Republic

Journal of Publication : Prague Med Rep

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21470500

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Massive pneumorrhachis, pneumocephalus and pneumoopticus following thoracic trauma and avulsion of the brachial plexus case report and review of the literature | Fibrositis and fibromyalgia

What our patients say ...

Consultant Spine Surgeon
Consultant Spine Surgeon
Consultant Spine Surgeon

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810