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Pocket of air found where man's brain should've been

14 March 2018

Miraculously, a report published in the British Medical Journal Case Reports revealed he was suffering no confusion, facial weakness, visual or speech disturbance, and the man said that despite the stumbles he was feeling well. He was otherwise fit and well, independent with physical activities of daily living (PADLs) and lived at home with his wife and two sons. In a way, they wouldn't be wrong.

Falls are a common problem among older adults, but for one 84-year-old man in Northern Ireland, a brain scan revealed a highly uncommon cause for his falls: A part of his brain appeared to be missing.

An 84-year-old man has declined surgery after a massive air-pocket was found in his brain. He said he had not. The condition is when a pocket of pressurized air forms within the cranium, which typically happens after brain surgery, the study's authors said.

The stunning scan revealed a large, black space behind his forehead, where the front of his brain should have been.

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An MRI would show the pneumatocele's likely cause was an osteoma, or benign bone tumour, that had formed in the man's sinus and was eroding through the base of the skull, Brown said. In this man's case, the air cavity formed in his brain measured 3.5 inches at its longest point, which is enormous.

"We immediately realized there was something significantly abnormal about the images, even before our specialist radiology team had given us the formal report", said Dr. Finlay Brown, a general practitioner trainee in Belfast, who was one of the doctors on call at the hospital at the time, in an email.

The MRI also revealed that the patient had experienced a small stroke related to the air pocket in his brain.

In addition to the alarming air pocket, the CT scan also disclosed that the man had a benign tumor in his skull. The patient was in otherwise ideal health, save for weakness on his left side and unsteady walking.

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His nonsurgical approach is not without risk: It's likely the patient will be at a greater risk for infection, since there remains a passageway for air - and therefore bacteria and viruses - into his brain cavity, Brown said.

Brown added that "unfortunately, as there are not many cases [of pneumocephalus] published, it is hard to know the exact prognosis". Usually, such air pockets are seen-on a smaller scale-in those who have undergone brain surgery.

According to the BMJ report, he had been prescribed medication to prevent another stroke and was also given instructions to monitor the feeling in his left side.

"Because every now and then", Brown told LiveScience, "there will be a rare (or) unknown causation of these that could be overlooked".

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Brown and his co-authors, however, emphasized in their paper symptoms like these should always be thoroughly explored and examined.

Pocket of air found where man's brain should've been