A Case of Extensive Pneumocephalus Following an Electric Scooter Accident

The use of electric scooters (e-scooters) has rapidly increased in Japan, accompanied by a rise in associated injuries. Severe head trauma can occur even when the Glasgow Coma Scale score suggests a mild injury, particularly when major clinical signs are present. Therefore, careful observation and appropriate management are essential. A 42-year-old woman injured by an e-scooter accident was transferred to our hospital with facial swelling and right vision loss. Head computed tomography revealed extensive pneumocephalus, skull base fractures, and traumatic subarachnoid hemorrhage. She subsequently developed status epilepticus, requiring rapid sequence intubation and deep sedation. Conservative management was adopted, and the pneumocephalus and a suspected cerebrospinal fluid leak resolved by day 8. The patient was discharged on day 21 without a consciousness disturbance. E-scooter-related trauma may conceal severe head trauma, even when initial neurological assessment suggests a mild injury. This case may suggest that prompt assessment and timely airway management are essential to prevent secondary brain injury in patients with extensive pneumocephalus.