Citation

Yanagawa Y, Fujita N, Ishikawa K. J. Emerg. Trauma Shock 2023; 16(2): 73-74.

Copyright

(Copyright © 2023, INDO-US Emergency and Trauma Collaborative, Publisher Medknow Publications)

DOI

10.4103/jets.jets_135_22

PMID

unavailable

Abstract

The high spatial and densitometric resolution of computed tomography (CT) means that it frequently reveals gas in tissues. CT often detects gas degeneration of the intervertebral disk as the vacuum phenomenon (VP).[1] The VP is observed at locations that experience traumatic impact; thus, an analysis of the VP may be useful for elucidating the mechanism of injury.[2] However, there have been no reports of the intracranial VP. We herein report the first case of pneumocephalus induced by traumatic VP.

A 15-year-old girl attempted suicide by leaping from the second story of her house after quarreling with her mother. Her head made direct contact with the concrete on the ground. She had a history of cutting her wrist a few times, but she had never been to a medical facility. Initially, she was in a deep coma and was transported to our hospital. On arrival, she was unconscious, but her other vital signs were stable. On a physical examination, she had contusions at the parietal region and severe neck pain without obvious quadriparesis. Whole-body CT showed diastatic bilateral coronal and anterior sagittal suture fractures with slight intra-extracranial air [Figure 1], right acute epidural hematoma, left subdural hematoma, and C7/Th1 dislocation fractures. Biochemical analysis of her blood showed values in the normal range. She became restless and confused, vomiting several times, likely due to intracranial hypertension so she underwent tracheal intubation under sedation and emergency removal of the left subdural hematoma and left decompressive craniotomy. After receiving intensive care, rehabilitation, and cranioplasty, she was transferred to another medical facility for rehabilitation on day 49.

Language: en

Keywords

adolescent; human; female; case report; rehabilitation; subdural hematoma; suicide attempt; vomiting; clinical article; sedation; automutilation; physical examination; coma; confusion; intensive care; restlessness; computer assisted tomography; antibiotic agent; endotracheal intubation; brain contusion; ego development; antibiotic therapy; neck pain; skull fracture; vertebra dislocation; epidural hematoma; medical history; intracranial hypertension; blood gas; open fracture; Letter; parietal lobe; cranioplasty; pneumocephalus; decompressive craniectomy; whole body CT; biochemical analysis; neurorehabilitation; cervical spine dislocation; intervertebral disk degeneration; sagittal suture; thoracic spine dislocation; traumatic vacuum phenomenon