Traumatic Cervical Pneumorrhachis: A Case Report and Review of the Literature

Document Type : Case Reports

Authors

1 Neurosurgery Department, Damanhour Medical National Institute (DMNI), Damanhour city

2 Neurosurgery, Damanhour Medical National Institute, Damanhour, Egypt

Abstract

Background Data: Pneumorrhachis means the presence of air inside the spinal canal. It is considered one of the rare findings among trauma patients. Most patients with pneumorrhachis are diagnosed with one or more of the following diseases: pneumocephalus, pneumothorax, and pneumopericardium. Pneumorrhachis can be isolated in cases of penetrating spinal injuries or combined in cases of skull base fractures.
Purpose: To report a traumatic cervical pneumorrhachis case.
Study Design: A case report.
Patients and Methods: A 37-year-old male patient presenting with a disturbed level of consciousness and evidence of severe head injury. No history of any chronic illness. He had multiple abrasions on the forehead and bilateral raccoons’ eyes after a history of a road traffic accident. Computed tomography (CT) scans over the skull and spine revealed the presence of air in the skull (pneumocephalus) and the cervical spinal canal (pneumorrhachis).
Results: The neurosurgical team reported one patient with pneumorrhachis. Endotracheal tube and multiple intravenous lines were inserted and further measures for stabilizing the hemodynamics were done. The patient was admitted into the Intensive Care Unit and treated conservatively with full recovery after 6 weeks of outpatient follow-up.
Conclusion: Pneumorrhachis is a rare spinal condition affecting the cervical spine. It is considered as an important radiological sign as it indicates the severe traumatic insult. Conservative medical treatment is the main way of management. The prognosis is related to the general condition of the patient and associated insults. (2019ESJ205)

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