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

MRI showing the cavity in the man’s skull

The man sought medical attention after several months of unsteady walking, multiple falls and weakness on his left side.

Still, there were no red flags in the man's medical history.

Staff chose to give the man a CT and MRI scan, and it was then that they saw the blank where some of his brain should have been, measuring 3.5 inches long.

Doctors found an interesting surprise when they examined an Irish man's brain: he seemed to be missing part of the organ.

"There was no confusion, facial weakness, visual or speech disturbance", the doctors wrote.

"We were able to see the brain scan images before receiving the formal report from our radiology specialists and immediately knew something was not right!" Dr. Finlay Brown told The Washington Post. He said he had not.

Generally, pneumocephalus appear after brain surgery, sinus infections or head and facial injuries. The condition is when a pocket of pressurized air forms within the cranium, which typically happens after brain surgery, the study's authors said.

In this case, the patient's pneumatocele - or pressurised air cavity - measured about 3.5 inches at its longest, according to the BMJ Case Reports article.

"To find a pocket of this size in an organized fashion was extremely uncommon, with very few documented cases found while I was researching for writing up the case report", Brown said.

The pneumocephalus, in this case, was caused by an osteoma, a benign bone tumor, that formed in the patient's sinuses and eroded through the base of his skull.

The tumour's formation and location had allowed for something of a "one-way valve effect" that had gradually contributed to the cranial air cavity, he added.

He said it had likely been forming over months, even years. "When the patient sniffed/sneezed/coughed he would most likely be pushing small amounts of air into his head".

He went on to experience a feeling of weakness in his left arm and leg over three days, which is when shocked medics at Causeway Hospital in Ireland discovered the massive air pocket where his brain should be.

Surgery is the most obvious treatment to remove the air pocket and to restore the man's brain cavity back to the correct shape.

But the patient said he had suffered none. However, due to the man's age and current state of health, he is declining surgery. He was given medication to prevent a secondary stroke and sent home with orders to monitor whether his left-side weakness worsened.

Dr Brown said the 84-year-old patient's case was a warning to other physicians not to write off common symptoms.

"Because every now and then, there will be a rare [or] unknown causation of these that could be overlooked", he told the science news site.

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