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Extensive pneumocephalus extending into the lateral ventricles from a brain abscess: an intracranial complication of cholesteatoma

Published online by Cambridge University Press:  07 December 2012

Y Tamura ,
M Suzuki ,
M Yamamoto  and
T Yoshida
Y Tamura
Affiliation:
Department of Otolaryngology, Sakura Medical Center, Toho University, Sakura City, Chiba, Japan
M Suzuki*
Affiliation:
Department of Otolaryngology, Sakura Medical Center, Toho University, Sakura City, Chiba, Japan
M Yamamoto
Affiliation:
Department of Otolaryngology, Sakura Medical Center, Toho University, Sakura City, Chiba, Japan
T Yoshida
Affiliation:
Department of Otolaryngology, Sakura Medical Center, Toho University, Sakura City, Chiba, Japan
*
Address for correspondence: Professor Mitsuya Suzuki, Department of Otolaryngology, Sakura Medical Center, Toho University, 564-1 Shimo-shizu, Sakura City, Chiba 285-0841, Japan Fax: +81 43 462 8741 E-mail: misuzuki-tky@umin.ac.jp
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Abstract

Objective:

We report the case of a patient with extensive pneumocephalus extending into the lateral ventricles from a brain abscess arising from a cholesteatoma-induced defect in the skull base.

Case report:

A 70-year-old man with cholesteatoma presented with right-sided otalgia, otorrhoea and progressive headaches. Computed tomography showed a tegmental defect (approximately 2 × 2 cm) at the right mastoid antrum. A T1-weighted, gadolinium-enhanced magnetic resonance imaging scan showed pneumocephalus in both lateral ventricles, which was directly connected to the mastoid cavity via a brain abscess and a bone defect in the skull base. Radical mastoidectomy was performed to remove the cholesteatoma. The roof of the mastoid cavity was covered extensively with fascia and a pedicled temporalis muscle flap. One week post-operatively, computed tomography and magnetic resonance imaging showed no pneumocephalus.

Conclusion:

Pneumocephalus arising from a cholesteatoma-induced brain abscess and extending into the lateral ventricles is an important entity, with an atypical appearance on computed tomography and magnetic resonance imaging.

Keywords

Otitis MediaBrain AbscessPneumocephalusComplications
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 2 , February 2013 , pp. 192 - 195
Copyright
Copyright © JLO (1984) Limited 2012

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