Pneumorrhachis in Acute Asthma Exacerbation in an 18-Year-Old Female Patient: A Report of a Rare Case

Pneumorrhachis (intraspinal air) is a rare radiological finding, often associated with trauma, iatrogenic causes, or increased intrathoracic pressures. We present a case of pneumorrhachis secondary to severe asthma exacerbation, highlighting its pathophysiology and clinical implications. An 18-year-old female patient presented with a history of dry cough, chest tightness, and pain in her neck. Subsequent scans, including chest X-rays and computed tomography (CT) scans, showed a large volume pneumomediastinum and pneumorrhachis. The patient was managed conservatively with bronchodilators, corticosteroids, and supplemental oxygen, leading to the resolution of symptoms and radiographic abnormalities. This case illustrates that pneumorrhachis can occur in asthma due to increased intrathoracic pressure, leading to air dissection into the spinal canal. Conservative management suffices in most cases, as seen here. Pneumorrhachis should be considered in severe asthma exacerbations with pneumomediastinum, even in the absence of neurological symptoms. Early recognition and treatment of the underlying asthma are crucial to prevent complications. This case adds to the limited literature on pneumorrhachis in non-traumatic settings.