A Case of Spontaneous Pheumocephalus Presenting with Tonic Clonic Seizure: A Case Report

The presence of cerebral air in the absence of a previous history of head trauma, neurosurgical surgery, or obvious infection is the defining characteristic of the uncommon clinical syndrome known as spontaneous pneumocephalus. The most prevalent causes of pneumocephalus include cranial surgery, paranasal sinus illness, skull base fractures, and barotrauma. Pneumocephalus manifests itself when there is a rupture in the skull or dura. On the other hand, it is quite uncommon for it to occur whenever there is no evident explanation. The slight, unnoticed abnormalities in the skull base, pressure gradients from Valsalva movements, and gas generation from concealed illnesses are some of the hypotheses that have been proposed as potential underlying causes for spontaneous instances.

From a clinical standpoint, spontaneous pneumocephalus can manifest itself with a wide variety of neurological symptoms. These symptoms might include headaches that are not unique to the condition, dizziness, altered sensorium, focal impairments, or indicators of raised intracranial pressure. Within this group of indications, seizure activity is a really rare occurrence. A diagnostic hurdle is presented by seizures as the initial presenting symptom. This is because seizures can easily be attributed to more common etiologies in the absence of a history of trauma or surgical procedures. In the event that a generalized tonic–clonic seizure is accompanied with spontaneous pneumocephalus, the diagnosis may be delayed depending on whether or not neuroimaging is performed as quickly as possible. Because of this, it is of the utmost importance to have a high level of clinical suspicion and to get imaging done as soon as possible in order to guarantee that this uncommon ailment is appropriately identified.

RODOLFO G. ROLDAN JR, RMT, MD, is an Second year Internal Medicine Resident at West Metro Medical Center, Zamboanga City, Philippines. He has a strong interest in rare neurological disorders and clinical case report. Rodolfo actively participates in academic conferences and poster presentations, focusing on unusual and educational cases to enhance clinical understanding. Through careful observation and study, he aims to highlight diagnostic challenges, promote early recognition, and contribute to evidence-based management of uncommon conditions, such as spontaneous pneumocephalus. His work reflects a commitment to advancing medical knowledge and improving patient care through scholarly engagement.