Traumatic air myelogram

M Ravi Krishna, K S Phaneendra, Venkat Raman Kola

Cite

Krishna RM, Phaneendra KS, Kola VR. Traumatic air myelogram. J Mech Vent 2023; 4(4):160-163.

Metrics

118 Downloads

Traumatic air myelogram

Abstract

We present the case of a 60-year-old male patient admitted to our intensive care unit after a high-velocity car accident. On-site clinical examination revealed normal consciousness with no focal deficits. Chest X–Ray was suggestive of right pneumothorax with pneumomediastinum and extensive subcutaneous emphysema. CT scan revealed right pneumothorax, pneumomediastinum, extensive subcutaneous emphysema and extradural pneumorachis. A right tube thoracostomy was done and the patient was placed on High flow nasal cannula at 40 lpm and 100% FiO2. There was a gradual resolution of pneumothorax and all the extra-alveolar air including pneumorachis by the 7th day. The patient was discharged in a clinically stable condition.

Keywords

Pneumothorax, Pneumomediastinum, Pneumorachis

References

1. Goh BKP, Ng KK, Hoe MNY. Traumatic epidural emphysema. Spine (Phila Pa 1976). 2004; 29(22): E528-30.
https://doi.org/10.1097/01.brs.0000144832.03555.f5
PMid:15543056
2. Hwang W, radiology HK-E, 2000 undefined. CT demonstration of spinal epidural air after chest trauma. Eur Radiol 2000; 10(2):396-397.
https://doi.org/10.1007/s003300050064
PMid:10663777
3. Gelalis ID, Karageorgos A, Arnaoutoglou C, et al. Traumatic pneumorrhachis: etiology, pathomechanism, diagnosis, and treatment. Spine J 2011; 11(2):153-157.
https://doi.org/10.1016/j.spinee.2010.12.010
PMid:21296300
4. Aujayeb A, Doe S, Worthy S. Pneumomediastinum and pneumorrhachis: a lot of air about nothing? Breathe 2012; 8(4):331-334.
https://doi.org/10.1183/20734735.010311
5. Allard E, Selim J, Veber B. Pneumocephalus and pneumorachis after blunt chest trauma without spinal fractures: a case report. J Med Case Rep 2019; 13(1):317.
https://doi.org/10.1186/s13256-019-2208-3
PMid:31651338 PMCid:PMC6813974
6. Salvati F, Signora M, Pedicelli G. Revisiting iatrogenic damage in pneumology past and current implications compared. Clin Ter 2012; 163(4):e233-241.
7. Amathieu R, Minville V, Poloujadoff MP, et al. Cervical post-traumatic pneumomyelogram: do not ignore this entity. Ann Fr Anesth Reanim 2004; 23(11):1089-1092.
https://doi.org/10.1016/j.annfar.2004.08.011
PMid:15581726
8. Sahu KK, Sanamandra P, Jeyaraman P, et al. Unusual cause of cord compression – A pressing issue for neurosurgeons. World Neurosurg 2016; 92:565-567.
https://doi.org/10.1016/j.wneu.2015.04.061
PMid:25963283
9. Amara B, Boujraf S, Benzagmout M, et al. Spontaneous pneumorrhachis and transverse myelitis complicating purulent meningitis. J Glob Infect Dis 2013; 5(4):179-182.
https://doi.org/10.4103/0974-777X.122019
PMid:24672182 PMCid:PMC3958990
10. Eroglu U, Yakar F, Zaimoglu M, et al. Pneumorrhachis. Asian J Neurosurg 2016; 11(2):172-173.
https://doi.org/10.4103/1793-5482.175641
PMid:27057230 PMCid:PMC4802945
11. Willing SJ. Epidural pneumatosis: a benign entity in trauma patients. AJNR Am J Neuroradiol 1991; 12(2):345.
12. Gonzales GR, Payne R, Portenoy RK, et al. Epidural air from a bronchopleural-epidural-cutaneous fistula producing reversible myelopathy and radiculopathy symptoms. Neurology 1994; 44(12):2409-2410.
https://doi.org/10.1212/WNL.44.12.2409
PMid:7991142
13. Krishnam, Mallick A. Air in the epidural space leading to a neurological deficit. Anaesthesia 2003; 58(3):292-293.
https://doi.org/10.1046/j.1365-2044.2003.306721.x
PMid:12603477
14. Nay PG, Milaszkiewicz R, Jothilingam S. Extradural air as a cause of paraplegia following lumbar analgesia. Anaesthesia 1993; 48(5):402-404.
https://doi.org/10.1111/j.1365-2044.1993.tb07013.x
PMid:8317649
15. Hazouard E, Koninck JC, Attucci S, et al. Pneumorachis and pneumomediastinum caused by repeated Müller’s maneuvers: Complications of marijuana smoking. Ann Emerg Med 2001; 38(6):694-697.
https://doi.org/10.1067/mem.2001.118016
PMid:11719752
16. Overdiek N, Grisales DA, Gravenstein D, et al. Subdural air collection: a likely source of radicular pain after lumbar epidural. J Clin Anesth 2001; 13(5):392-397.
https://doi.org/10.1016/S0952-8180(01)00272-0
PMid:11498324