From the Departments of Neurology (Drs. Bernstein and Cassidy); Emergency (Dr. Duchynski); and Medical Imaging (Dr. Eisenberg), Kaiser Permanente Medical Center, Santa Rosa, CA.
Atypical Headache After Prolonged Treatment With Nasal Continuous Positive Airway Pressure
Article first published online: 9 JUN 2005
Headache: The Journal of Head and Face Pain
Volume 45, Issue 5, pages 609–611, May 2005
How to Cite
Bernstein, A. L., Cassidy, J., Duchynski, R. and Eisenberg, S. S. (2005), Atypical Headache After Prolonged Treatment With Nasal Continuous Positive Airway Pressure. Headache: The Journal of Head and Face Pain, 45: 609–611. doi: 10.1111/j.1526-4610.2005.05117_3.x
- Issue published online: 9 JUN 2005
- Article first published online: 9 JUN 2005
- Accepted for publication January 6, 2004.
- case report;
We report a case of atraumatic pneumocephalus associated with prolonged use of nasal continuous positive airway pressure. Initial symptoms included headache, ataxia, vertigo, and a “gurgling” sensation in the head; and a CT image showed small air bubbles along the falx of cerebrum and adjacent to the temporal epidural spaces bilaterally. Although no evidence of cerebrospinal fluid (CSF) leak was either reported by the patient or found at initial clinical examination, subsequent nasal discharge tested positive for β2-transferrin, a finding consistent with CSF leak in the paranasal sinus region or through the cribriform plate. To try to prevent infection from an open communication between the paranasal sinuses and intracranial structures, an attempt should be made to localize the anatomic defect.