Cape Town, South Africa

Author Affiliations: Trauma Unit, Department of Pediatric Surgery, Trauma Unit Red Cross War Memorial Children's Hospital, 6th floor, ICH Building, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch 7701, Cape Town, South Africa (Gill HS, van As AB)

Corresponding Author: Prof AB van As, MBChB, FCS(SA), MMed, MBA, PhD (UCT), Trauma Unit, Department of Pediatric Surgery, Trauma Unit Red Cross War Memorial Children's Hospital, 6th floor, ICH Building, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch 7701, Cape Town, South Africa (Tel: +27-21-6585012; Fax: +27-21-6856632; Email: Sebastian.vanas@uct.ac.za)

Background: To report a case of fatal tension pneumocephalus in a 9-year-old boy following a severe motor vehicle accident.

Methods: A young boy with a serious closed head injury was resuscitated in the emergency room and underwent CT scan of the head and orbits.

Results: The CT-scan revealed a fracture of the orbital roof with extensive bilateral pneumocephalus.

Conclusions: A high index of suspicion for tension pneumocephalus is required in patients with severe head injuries presenting with periorbital swelling and perioccular trauma. A prompt CT scan and neurosurgical intervention are indicated.

Key words: head injuries; peri-ocular trauma; pneumocranium; trauma

                                                                                                        World J Pediatr 2008;4(3):231-233