Pneumorachis and pneumocephalus: Case report of a rare blunt chest trauma complication

INTRODUCTION: Pneumorachis, air in the spinal canal, is very rare and its association with pneumocephalus following blunt thoracic trauma remains exceptionally uncommon. CASE PRESENTATION: We present the case of a 65-year-old patient, a pedestrian hit by a car driving at very high speed. The lesion assessment on admission showed a bilateral hemothorax of moderate abundance, a right pneumothorax of low abundance and a left pneumothorax of moderate abundance, subcutaneous cervico-dorsal emphysema, pneumocephalus and significant pneumorachis at the cervico-dorsal level without fracture of the base of the skull, sinuses or the spine. DISCUSSION: We discuss the different etiologies of pneumorachis, the main hypotheses of the constitution of this air effusion and the principles of management. CONCLUSION: Pneumorachis associated with pneumocephalus in a traumatic context without bone lesions is an extremely rare entity, its discovery should lead to further investigations to look for any spinal or basilar skull fracturethat could expose to an infectious risk or require a surgical procedure.