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
Late last year, I met my new 64 year-old clinic patient who just moved into town. During a brief discussion about preventive health, I asked her when she had her last colonoscopy for colon cancer screening. She emphatically responded: “Never. I will probably be dead in 10 years anyway [from an unrelated cause]“. Her view on life may have been surprising, but her reluctance to obtain a colonoscopy wasn’t. Who could blame her? The prospect of having a scope inserted into the rectum and advanced through the colon is not appealing. Fortunately, there are alternate modalities for colon cancer screening, two of which (stool DNA and virtual colonoscopy) have just been added to official guidelines.
Open MRI of Canada, a private clinic in Calgary, recently introduced the very first open MR (magnetic resonance) imager in the country. The company is marketing the new device as a viable alternative for certain patient populations, such as obese individuals who cannot fit in the confined spaces of the traditional MRI. This would also be helpful for patients with claustrophobia and for anxious children who can now be accompanied by their parents.
