83-year-old man with acute-onset headache 83岁老年男性，突发头痛History: An 83-year-old man, admitted several days prior for a complex pelvic surgery, complains of acute-onset headache.病史：83岁老年男性，数日前因拟行骨盆手术入院，自诉突发头痛A CT scan of the head was performed. Axial images are shown below. Click to enlarge.
FindingsCT shows a small amount of air in the temporal horn of the left lateral ventricle and the frontal horn of the right lateral ventricle.影像学表现CT可见左侧侧脑室颞角及右侧侧脑室额角少量气体影。Diagnosis: Intraventricular pneumocephalus诊断：脑室积气Additional information and questionsThe patient presented in this case had been admitted several days prior for a complex pelvic surgery, after which he developed severe and persistent pelvic pain. An epidural line was placed for pain control earlier on the same day before the patient developed his sudden acute-onset headache.补充信息和问题该病例中患者因拟行骨盆手术几日前入院，随后出现剧烈持续骨盆疼痛。硬膜外埋线止痛后不久出现突发头痛。iscussionIntraventricular pneumocephalus after epidural intervention硬膜外介入治疗后出现脑室积气。Pneumocephalus after epidural interventions has been reported uncommonly in the literature. The cause of intraventricular air may be due to incidental puncture of the dural sac and intrathecal injection. Symptoms typically occur immediately after pneumocephalus development. A very small volume of air can result in symptoms.少量文献报道硬膜外介入治疗后出现颅腔积气。脑室内气体可能源于硬膜囊意外穿通和鞘内注射。颅腔积气后即刻出现相应症状。少量气体即可出现症状。Given the rarity of case reports, no definite management is established. However, high concentration oxygen has been recommended in some references, which may have arisen from the effectiveness of hyperbaric oxygen in the treatment of cerebral air embolism. The intraventricular air is typically reabsorbed in several days with resolution of symptoms in a similar time frame.鉴于文献报道罕见，暂时没有明确的治疗方法。然而，部分文献建议高浓度氧治疗，可能借鉴于高压氧治疗颅内空气栓塞。数日后脑室气体吸收，随之症状即缓解。关键词：Temporal /'tɛmpərəl/ 颞叶的Frontal /'frʌntl/ 额叶的Pneumocephalus 颅腔积气Epidural /'ɛpə’djʊrəl/ 硬膜外的Dural sac 硬膜囊Intrathecal /ˌɪntrə'θikl/ 鞘内的Hyperbaric oxygen 高压氧
