Intraparenchymal tension pneumatocele complicating frontal sinus osteoma: Case report

OBJECTIVE AND IMPORTANCE: A relatively rare condition of intraparenchymal tension pneumatocele secondary to a frontal sinus osteoma eroding posteriorly and breaching dura mater is described. The scanty body of literature on this subject is briefly summarized, and the importance of this condition as a result of its life-threatening but readily treatable intracranial mass effect is outlined. CLINICAL PRESENTATION: The patient presented with acute deterioration in conscious state and lateralizing signs from the mass effect of gas under tension. Two weeks earlier, he had experienced vague and subtle changes in personality noticeable only to his family. INTERVENTION: The patient was cured by a frontal craniotomy, partial excision of the osteoma, and suture repair of the dural defect after evacuation of the pressurized air cavity. CONCLUSION: This rare condition should be urgently treated in the event of acute deterioration. To prevent a life-threatening situation from arising, elective surgery should be considered for patients known to have air sinus osteomas that are at risk of erosion into the cranial cavity.