An Unusual Case of Non-traumatic Tension Pneumocephalus

Tension pneumocephalus is a life-threatening situation in neurosurgery. It can occur due to various causes, such as trauma, complications of neurosurgery or sinus surgery, and also in conditions where there is a CSF leak. We present an unusual case of a 53-year-old woman who came with complaints of severe headache and CSF rhinorrhea. On radiologic evaluation, tension pneumocephalus was noted as a result of sphenoid encephalocele. Sphenoidal encephaloceles are herniations of brain parenchyma, meninges, and CSF through a defect in the sphenoid bone. It typically presents as CSF rhinorrhea. Rarely, tension pneumocephalus can occur in the form of a severe headache. The recognition of clinical and radiologic features can help in making an accurate diagnosis of this rare condition at the earliest.