1. Esophageal-subarachnoid fistula: a case of spontaneous tension pneumocephalus in the setting of esophageal cancer.
- Author
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Patel MR, Idicula W, Carrau RL, and Prevedello DM
- Subjects
- Aged, Anti-Bacterial Agents therapeutic use, Decompression, Surgical methods, Emergencies, Esophageal Fistula complications, Esophageal Fistula diagnostic imaging, Esophageal Fistula therapy, Headache etiology, Humans, Hyperbaric Oxygenation, Male, Neoplasm Staging, Pneumocephalus diagnostic imaging, Pneumocephalus therapy, Radiography, Treatment Outcome, Carcinoma, Squamous Cell complications, Esophageal Fistula etiology, Esophageal Neoplasms complications, Pneumocephalus etiology, Subarachnoid Space
- Abstract
Background: Pneumocephalus occurs as a result of traumatic or iatrogenic violation of the dura. Tension pneumocephalus, whereby air continues to accumulate with no mechanism for escape, can cause significant morbidity and mortality., Methods: This case report reviews the underlying pathophysiology, clinical presentation, diagnosis, and management of tension pneumocephalus., Results: We present the case of a 68-year-old man who presented to the Emergency Department with headache thought to be the result of a newfound intracranial mass. After admission, he became obtunded and was found to have tension pneumocephalus requiring emergent evacuation. A cervical esophagus carcinoma caused an esophageal-subarachnoid fistula that resulted in tension pneumocephalus after a retching episode., Conclusion: This case illustrates the importance of considering alternative sources of pneumocephalus in the absence of more typical differential diagnosis., (© 2013 Wiley Periodicals, Inc.)
- Published
- 2014
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