Published: Wed, March 14, 2018
Medical | By Johnnie Horton

Man's 'Missing' Brain Was Actually a Large Air Pocket Inside His Head

Man's 'Missing' Brain Was Actually a Large Air Pocket Inside His Head

Still, there were no red flags in the man's medical history.

He noted his left arm and leg had also become weaker but his apparent fitness and lack of "confusion or facial weakness" led doctors to believe there was nothing obvious, aside from age, to explain his symptoms. He was otherwise fit and well, independent with physical activities of daily living (PADLs) and lived at home with his wife and two sons. Dr. Finlay Brown, co-author and physician at Causeway Hospital in Northern Ireland, told Newsweek via email.

The most common causes for pneumocephalus include a sinus infection or serious facial trauma.

It later turned out that the pneumocephalus, which means there is air in the cranium, has probably been caused by a benign bone tumour which means the base of the skull has eroded allowing air in, likely to have been going on for months and years.

In this case, the patient's pneumatocele - or pressurised air cavity - measured about 3.5 inches at its longest, according to the BMJ Case Reports article.

While the man could have undergone surgeries he declined due to his age and other health factors.

"To find a pocket of this size in an organized fashion was extremely uncommon, with very few documented cases found while I was researching for writing up the case report", Brown said.

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He said it had likely been forming over months, even years. These air pockets are seen more commonly in patients who have facial trauma or infections, or who have had brain surgery, according to a report of the case, published February 27 in the journal BMJ Case Reports.

The doctors determined that the osteoma wore away part of the ethmoid bone, which allowed air to be pushed, under pressure, into his brain, "creating a "one-way valve" effect", the report said. Those types of cavities are typically found in patients who've had brain surgery or various types of infections. He was later discharged and put on a secondary stroke prevention program, after which his left-sided weakness appeared to have been resolved.

But, Brown and his colleagues questioned the patient and learned he never experienced either of those.

Brown added that "unfortunately, as there are not many cases [of pneumocephalus] published, it is hard to know the exact prognosis".

A profile view showing the large air pocket trapped inside a man's head.

Brown and his coauthors, however, stressed in their paper that symptoms like this patient's should always be thoroughly explored.

"Because every now and then, there will be a rare [or] unknown causation of these that could be overlooked", he told the science news site.

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