Traumatic pneumorrhachis/pneumomediastinum pathogenesis, diagnosis and management

Author: 
Pazooki D., Zeratiaan S., Yousefnia., Hosseini M., Mesbah M., Granhed H., Jalilifar N., Khamooshi AJ and Haghighikian M and AR Ghavidel MD

Traumatic pneumorrhachis is a rare but known complication of basilar skull fracture with air localized in the cervical subarachnoid space. Pneumorrhachis the presence of intraspinal air, is an exceptional but eminent radiographic finding, accompanied by different aetiologies and possible pathways of air entry into the spinal canal. Extradural, intraspinal and epidural air may also be associated with other traumatic aetiologies.
The incidental finding of intraspinal air in the trauma setting mandates a search for the etiology.
Pneumomediastinum is uncommonly associated with pneumorachis. The condition can be caused by injury or disease. Most often, it occurs when air leaks from any part of the lung or airways into the mediastinum.
Method: By reviewing the literature and analysing a personal case of traumatic cervical and thoracic pneumorachis, pneumomediastinum aftermultitrauma, we present current data regarding the pathoanatomy, clinical and radiological presentation, diagnosis and differential diagnosis and treatment modalities of patients with pneumorachis, pneumomediastinum and associated pathologies to highlight this uncommon phenomenon and outline aetiology-based guidelines for the practical management of these conditions.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2018.13918.2502
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