The figurative use of the word “airhead” originated in the late 1970’s and signified a simple-minded or stupid person. But what are the characteristics of the literal “airhead” (or in medical jargon, pneumocephalus)? Does this person also exhibit similar deficits in cognitive function?
The New England Journal of Medicine recently featured the case of an Argentinian patient who spontaneously developed the so-called pneumocephalus. She is a 54 year-old woman who experienced progressive visual, auditory, and speaking abnormalities. A head radiograph demonstrated an air pocket along her left temporal region (enlarged image). A computed tomography (CT) scan revealed similar findings, with the pocket measuring 4 cm x 3 cm x 5 cm. There was no evidence of fracture or trauma.
The cause of the woman’s sensory and speech deficits can be explained by the air compressing against her brain, with indirect compromise of her brainstem. Her symptoms resolved soon after undergoing neurologic surgery to decompress the air and to repair a defect in an adjacent bone (mastoid). No tumor or infection was noted. Although most cases of pneumocephalus occur secondary to head trauma, it is possible the mastoid bone defect discovered during surgery may have been the source for air to enter the skull.
On a lighter note, the next time someone accuses you of being an airhead, you could refute him figuratively and literally with the following response: “I do not manifest the typical characteristics of pneumocephalus”.
- Sources
- Villa RA, Capdevila A. Spontaneous otogenic pneumocephalus. NEJM 2008;358:e13.
- Image Copyright: New England Journal of Medicine
I have to admit, pneumocephalus is something I have never even thought about existing before. Hydrocephalous and of course bleeds in the brain. But air just kind of blows my mind.
There are also other instances of air acting as a foreign body. Air in the chest cavity can cause a pneumothorax, and air in the blood are termed “air emboli”. Prophylaxis against the latter is the reason syringes are flushed prior to injection (this is frequently seen on television, when the mad professor holds the syringe vertically and squirts out a few milliliters of toxin prior to injecting his victim).
An interesting aspect of this case is that a source for the air has not been definitively identified, although the mastoid bone defect would be a plausible point of entry. The report did not comment on leaking CSF (cerebrospinal fluid), particularly with the increase in intracranial pressure (ICP) generated by the air mass. On the other hand, it is possible that miniscule amounts of CSF in the mastoid cavities would be difficult to detect amid all the blood and CSF draining everywhere during neurosurgery.
When I learn to pronounce this diagnosis, I have a few friends I want to try it out on. Also, I have a few acquaintances who may well suffer from this malady as they certainly exhibit some of the behavioral symptoms.Very interesting post.
That would have been a very satisfying xray to have taken
Nice post