Pneumoencephaly is usually a complication of head trauma or craniotomy. We present a patient with large pneumoencephaly with acute neurological deficit after frequent falls, but without recent major trauma or surgery. Skull X-ray films show intracranial air in the frontal region and in the 2nd, 3rd, and 4th ventricles, reminiscent of an pneumoencephalogram. Computed tomography (CT) of the head shows air in the right frontal region and lateral ventricles. After craniotomy to relieve the pressure of the air, the clinical condition of the patient improved significantly after six months.
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