Clinics in diagnostic imaging (119)

A 36-year-old man presented with cerebrospinal fluid rhinorrhoea after head injury in a road traffic accident three weeks prior to presentation. Magnetic resonance (Mr) imaging demonstrated a hypointense cavity in the left frontal lobe communicating with the frontal horn of the left lateral ventricle, consistent with an intracerebral pneumatocele. The fistulous track communicating with the frontal sinus was demonstrated on the sagittal and coronal images. The patient underwent surgical decompression of the cavity and repair of the dural defect and fracture of the frontal bone. Postoperatively, the patient made excellent recovery. An intracerebral pneumatocele should be recognised on MR imaging, as potential complications include tension pneumocephalus and meningitis, and surgical treatment is indicated in most of the cases.