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Air can get in - but not out: huge hole discovered in an old man's skull
In Northern Ireland, an elderly man who was hospitalized after a series of falls has stunned the doctors. The doctors found a huge air-filled cave where part of his brain should have been. However, the patient decided against surgery.
Complaints indicated a stroke
According to media reports, an 84-year-old man was referred to a hospital by his doctor in Northern Ireland after a series of falls. According to the information, the patient had been feeling insecure on his feet for months, fell more often and felt weak in his left arm and leg the three days before the hospital admission. The symptoms suggested a stroke. But the complaints were caused by another problem: the patient had a huge hole in the skull.
Air-filled cavity in the skull
As the British newspaper "The Guardian" reports, initial blood tests in the clinic showed nothing unusual.
The patient also showed no signs of facial weakness, speech problems, or confusion.
The 84-year-old was fit and healthy, did not need help with physical activities, did not smoke and rarely drank alcohol.
In examinations with computed tomography (CT) and magnetic resonance tomography (MRT), the medical team finally discovered a nine-centimeter-sized air-filled cavity in the right frontal lobe of the brain.
In addition, they found a benign bone tumor on the paranasal sinuses, as the doctors report in the journal "BMJ Case Studies".
Air could penetrate when sneezing and coughing, among other things
According to co-author Dr. Finlay Brown's tumor "has grown slowly over time, putting pressure on the base of his skull and causing minor erosion."
He went on to explain: “And because air flows through the sinuses, the air can move through it and through the erosion into the skull.”
According to Brown, the eroded area and the tissue over it formed a one-way valve. "The air can get in, but it can't get out," says the doctor.
And this is especially the case when there is high pressure, such as when sneezing or coughing.
The scans looked like part of the brain had disappeared, but according to Brown, it hadn't; rather, the air cavity had compressed the brain.
Patient refused surgery
The patient was offered the option of surgery to reduce pressure in the brain, correct erosion, and remove the tumor.
However, the 84-year-old decided not to have the procedure performed because of the possible risks and was discharged from the clinic.
According to the authors, the patient's left-sided weakness disappeared after twelve weeks, but what happens next is unclear.
“In theory, the brain could possibly absorb some of the air, or the body could absorb something, but it could also get worse. We just don't know, ”Brown said, adding that there is also a risk of infection and a risk of stroke.
"He actually had a small stroke, probably due to the pressure over time, and I suspect there is a risk that this will happen again," said the doctor. According to Brown, the patient was treated preventively.
The doctor also explained that he had seen air in other patients' skull cavities earlier, but the size and location of the air chamber was remarkable in the case of the 84-year-old.
"I've never seen anything like it," said Brown. "I cannot imagine that I will ever see it again." (Ad)