Pneumorrhachis: An uncommon radiological entity (original) (raw)
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European Journal of Radiology Extra, 2009
Pneumorrhachis (PR) is an under-diagnosed phenomenon delineating existence of intraspinal air. We report a case in which extradural PR developed along with pneumoretroperitoneum, pneumomediastinum, cervical, thoracic and abdominal wall subcutaneous emphysema after retroduodenal perforation following ERCP. ERCP was done to evaluate obstructive jaundice in a 62-year-old male following which patient developed abdominal pain and crepitus in the body wall. Computerized tomography scan revealed extradural pneumorrhachis of thoraco-abdominal spinal canal with presence of air in the body cavities. The patient remained however neurologically asymptomatic and recovered with conservative management over the next few days. We have also studied the available literature and presented a pathway of air dissection from the body cavities to the epidural space.
Spontaneous epidural air entrapment
The Ochsner journal, 2014
Epidural pneumorrhachis (EPR), an extension of pneumomediastinum, results from air that leaks from the mediastinum and accumulates in the epidural space of the spine. It is an uncommon, benign condition; most cases are asymptomatic, are recognized only on computed tomography scans, and require no treatment. We present a case of EPR, pneumomediastinum, pneumothorax, and subcutaneous emphysema in a young male who was managed conservatively with supportive care. EPR is a rare yet benign condition that can be found incidentally while working up lung or spine pathology. Although radiography can define the presence of a pneumomediastinum and subcutaneous emphysema, the diagnosis of EPR can only be made using computed tomography. The management of EPR is usually conservative, and the focus should be on underlying disease.
Spontaneous Pneumorachis – A Case-Based Review
Journal of Asthma and Allergy, 2021
Pneumorachis is characterized by the presence of free air in the spinal canal. It is referred by different names in literature such as epidural emphysema, intraspinal air, intraspinal pneumoc(o)ele, spinal epidural and subarachnoid pneumatosis, spinal and epidural emphysema, aerorachia, pneumosaccus, air myelogram, etc. Pneumorachis can be broadly classified as traumatic, iatrogenic, or spontaneous. In this case-based review, we present a case of spontaneous pneumorachis secondary to asthma exacerbation. This is followed by a systematic review of all cases of spontaneous pneumorachis identified in PubMed. The aim of this review is to understand the pathophysiology, common causes and the management of spontaneous pneumorachis.
Epidural emphysema associated with primary spontaneous pneumothorax
European Journal of Cardio-Thoracic Surgery, 2001
A 21-year-old male patient was admitted with spontaneous pneumothorax, and no history of asthma. Closed drainage treatment was unsuccessful. Chest computed tomography demonstrated pneumomediastinum and subcutaneous emphysema with multiple air bubbles within the spinal canal between the levels Th3 and Th11. Resection of bullae on the upper lobe and partial pleurectomy were performed. Postoperative period was uneventful. Epidural emphysema was resolved spontaneously without neurologic symptoms and signs. Intraspinal air, or pneumorachis, associated with spontaneous pneumothorax and pneumomediastinum is an extremely rare condition. We discussed spontaneous pneumothorax and pneumomediastinum as well as epidural pneumatosis and reviewed reported cases in the literature.
Pneumomediastinum associated with pneumopericardium and epidural pneumatosis
Case reports in emergency medicine, 2014
Spontaneous pneumomediastinum is a relatively rare benign condition. It may rarely be associated with one or combination of pneumothorax, epidural pneumatosis, pneumopericardium, or subcutaneous emphysema. We present a unique case with four of the radiological findings in a 9-year-old male child who presented to our emergency department with his parents with complaints of unproductive cough, dyspnea, and swelling on chest wall. Bilateral subcutaneous emphysema was palpated on anterior chest wall from sternum to midaxillary regions. His anteroposterior and lateral chest radiogram revealed subcutaneous emphysema and pneumomediastinum. His thorax computed tomography to rule out life-threatening conditions revealed bilateral subcutaneous, mediastinal, pericardial, and epidural emphysema without pneumothorax. He was transferred to pediatric intensive care unit for close monitorization and conservative treatment. He was followed-up by chest radiographs. He was relieved from symptoms and s...
Progressive subcutaneous emphysema. A rare finding: Pneumorrhachis
Respiratory Medicine Case Reports
Pneumorrhachis is a rare phenomenon which may be caused by trauma, intracraneal infection, pneumomediastinum or iatrogenic factors. Presence of air in the spinal canal is reported in most cases. In this article, we report a case with PR in the spinal canal without any neurological deficit, which developed secondary to subcutaneous emphysema.
Spontaneous cervicothoracolumbar pneumorrhachis, pneumomediastinum and pneumoperitoneum
The Clinical Respiratory Journal, 2009
Introduction: Pneumorrhachis, or epidural pneumatosis, is a rare entity that is usually traumatic or iatrogenic. Usually, the epidural emphysema is limited to a few vertebral spaces. Less commonly, it is secondary to mediastinal air that tracks into the epidural space. Mediastinal air is usually associated with subcutaneous emphysema, but rarely is it associated with pneumopericardium or pneumoperitoneum. The cause of pneumomediastinum is usually identifiable on history or radiology. Methods: Report of a case. Results: We report the extremely rare simultaneous occurrence of self-limiting cervicothoracolumbar pneumorrhachis, pneumomediastinum, cervical subcutaneous emphysema and pneumoperitoneum in a healthy 20-year-old gentleman in the absence of an identifiable cause.c rj_116 239..243 Conclusion: Extensive pneumorrhachis and pneumoperitoneum may simultaneously accompany pneumomediastinum and subcutaneous emphysema in the absence of an identifiable cause and still follow a benign clinical course.
Closed Thoracic Trauma as an Exceptional Cause of Pneumorrhachis: A Case Report
Curēus, 2024
Pneumorrhachis, a rare clinical entity, refers to the presence of air in the spinal canal. Air can enter the spinal canal through various pathways, including the lungs and mediastinum (the space between the lungs), or directly from external sources due to trauma or infection. In rare cases, pneumorrhachis may result from repeated secondary Valsalva maneuvers, which is a complication of large-area pneumothorax. In this case report, we discuss a 36-year-old male patient who was involved in a high-intensity road accident. The injury assessment revealed significant findings including a large left pneumothorax, a right pneumothorax, multiple rib fractures, and the presence of pneumorrhachis. The entry of air into the spinal canal originated from the pleural space, likely through injuries to the parietal pleura. Rarely reported, closed thoracic trauma is an exceptional cause of pneumorrhachis. This unique mechanism of injury has been described in a limited number of publications addressing traumatic pneumorrhachis. The identification of pneumorrhachis in a traumatized patient should prompt further investigation to explore other potential injuries that may elucidate the formation of this intraspinal gas collection.
Pneumorachis of the cervical spine with associated pneumocephalus and subcutaneous emphysema
Indian Journal of Orthopaedics, 2011
Pneumorachis, the presence of free intraspinal air, is an exceptional radiological finding. We present a case that sustained injury following an assault and was diagnosed to have diffuse pneumocephalus, pneumorachis and extensive surgical emphysema of the head and neck region secondary to the fracture of the cribriform plate of ethmoid bone. To the best of our knowledge pneumorachis due to fracture of the cribriform plate of ethmoid bone has not been reported before, in the English language literature.