Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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May 19, 2014
Pneumorrhacis
- Clinical Presentation: Usually asymptomatic
- Classification: Intradural, subdural or subarachnoid, and extradural
- Causes: Idiopathic, traumatic, or nontraumatic secondary to increased intrathoracic pressure, such as in asthma, repeated vomiting from diabetic ketoacidosis, inhalation of recreational drugs like ecstasy or marijuana.
- Key Diagnostic Features: CT will demonstrate gas within the spinal canal and also show any associated injuries/pathologies.
- Pathomechanism: 1) Direct entry from penetrating trauma; 2) air entraps due to one-way valve mechanism and resultant air dissection through paraspinal tissues to spinal canal; and 3) repeated Müller's maneuvers
- Rx: The air gets reabsorbed completely with conservative management.
- Complications: Spinal cord compression (very rare)
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