Spontaneous pneumocephalus is currently a rare manifestation of chronic otitis media. Although a rarity, the diagnosis must be considered when a patient has neurologic complaints and chronic otitis media. Despite the importance of early recognition and treatment in preventing potentially fatal complications, it has been noticeably neglected in recent otolaryngologic literature. We report a case, review the literature, and discuss the related pathophysiology. This case demonstrates the need for at least skull roentgenograms in patients with positive neurologic history and chronic otitis media and the danger of neglecting the proper treatment of cholesteatoma.
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