Pneumocephalus is the presence of air within the skull due to fistulous tract formation via the paranasal sinuses, tegmen tympani, or mastoid air cells. It may result from penetrating wounds, fractures, erosions from tumors or infections, craniotomy or sinus surgery; or it may occur spontaneously.1 Pneumocephalus as a complication of a penetrating orbital wound has been reported on two previous occasions.Slaughter and Alvis2 reported a three-year-old girl who developed severe purulent orbital cellulitis following a pencil injury to the right upper lid. The ophthalmologists caring for the child felt that she had a right frontal brain abscess with gas-forming bacilli. There was a lobulated area of radiolucency in the frontal lobe with some bubbling of gas from the orbital wound during aspiration of pus for culture. A consultant neurosurgeon thought that this was a traumatic pneumoencephalocele. Neurological evidence for a brain abscess was minimal. The cultures
BARD LA. Pneumocephalus Secondary to a Penetrating Orbital Wound: Report of a Case. Arch Ophthalmol. 1963;70(2):232–235. doi:10.1001/archopht.1963.00960050234014
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