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Pneumoencephalus after one missed step

Case

An 82-year-old female sustained a ground level fall after missing a single step while Christmas shopping. She arrived at the emergency department with stable vital signs, but with massive facial bleeding threatening her airway. We proceeded with emergent nasal packing and endotracheal intubation. CT of head and face revealed massive pneumoencephalus (Fig. 1) secondary to complete disruption of the facial complex from the cranium, consistent with LeFort I, II and III fractures (Fig. 2). The patient was taken to surgery and subsequently extubated on day 2 without neurological deficit.

Fig. 1
figure1

CT of head and face revealed massive pneumoencephalus

Fig. 2
figure2

Complete disruption of the facial complex from the cranium, consistent with LeFort I, II and III fractures

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Correspondence to Daniel Cabrera.

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Cabrera, D., Gilmore, R. & Klocke, D.L. Pneumoencephalus after one missed step. Int J Emerg Med 1, 145 (2008). https://doi.org/10.1007/s12245-008-0025-3

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Keywords

  • Public Health
  • Internal Medicine
  • Emergency Department
  • Emergency Medicine
  • Neurological Deficit