Abstract Details

Title Spontaneous Tension Pneumocephalus Complicated by Secondary Meningitis: A Rare Case Report and Review of Literature

Topic Infectious Disease

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 3-008

Objective To report a rare case of spontaneous tension pneumocephalus associated with secondary meningitis.

Background Spontaneous pneumocephalus is the abnormal presence of gas in the cranial cavity representing less than 1% of all pneumocephalus cases without any apparent cause, such as trauma, surgery, or an underlying medical condition, making it an exceptionally rare occurrence. It has an exceedingly rare association with meningitis. The clinical presentation often ranges from being asymptomatic to headaches, nausea, and dizziness and, in severe cases, can progress to tension pneumocephalus, which is a medical emergency, characterized by seizures, altered mental status, and focal neurological defects.

Design/Methods NA

Results A 30-year-old female presented with headache, fever, recurrent seizures, and clear nasal discharge. The neurologic exam showed meningeal signs without focal deficits. There was no history of trauma, neurosurgical intervention, or recent sinus infections. CSF analysis revealed neutrophilic pleocytosis, low glucose level, and elevated protein consistent with bacterial meningitis. CT scan of the brain displayed extensive intracranial air collections with compression of the frontal lobe, referred to as the Mount Fuji sign, indicative of tension pneumocephalus. MRI brain revealed mild subdural loculated collections in the anterior interhemispheric fissure, mucosal thickening of the ethmoid and sphenoid sinuses, and hyper-pneumatization of bilateral frontal sinuses. The patient was managed conservatively with high-dose intravenous antibiotics. The likely source was a spontaneous skull base defect with secondary bacterial meningitis. MRI repeated after one month exhibited near-complete resolution of the pneumocephalus and associated inflammatory changes.

Conclusions Spontaneous pneumocephalus with secondary meningitis represents a rare but clinically significant entity that requires prompt recognition and appropriate management. This case underscores the value of early diagnosis and a multidisciplinary approach.

Authors/Disclosures
Muhammad Moiz Javed, MD PRESENTER	Dr. Javed has nothing to disclose.
Hassan Mehdi, MBBS	Dr. Mehdi has nothing to disclose.
Syed Mohsin Raza Bukhari, MBBS	Dr. Bukhari has nothing to disclose.
Ghazi Abdullah, MBBS	Dr. Abdullah has nothing to disclose.
Umema Shanza, Manager	Ms. Shanza has nothing to disclose.
Areesha Zafar, MBBS	Miss Zafar has nothing to disclose.
Amna Zaheer	Miss Zaheer has nothing to disclose.
Muhammad Salman Sajid, MBBS	Mr. Sajid has nothing to disclose.
Syed Ijlal Ahmed, MD, MBBS	Dr. Ahmed has nothing to disclose.

��ɫ��

��ɫ��