Pneumocephalus is often a complication of head trauma and cranial surgeries. Massive intraventricular pneumocephalus is an uncommon entity. We report the cases of two patients presenting same day with a clinical diagnosis of open head injury following separate road traffic accidents whose computed tomography (CT) brain images confirm skull base and vault fractures with massive pneumocephalus and tension pneumoventricles. CT scan remains invaluable in proper evaluation of head injury, and its complications for early and appropriate intervention toward reducing morbidity and mortality.
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