“Post Traumatic Brain Abscess Mimicking as Pneumatocele”: An Uncommon Presentation

Pneumatocele is a very rare complication that follows head injury. Pneumatocele can result due to a craniodural fistula, formed either after a fracture involving air sinuses, roof of middle ear, or depressed fracture of skull. Gas-containing brain abscess is a life-threatening condition, which requires immediate diagnosis and prompt therapeutic intervention. The predisposing factors include hematogenous spread, contiguous infection, and abnormal fistulous communication due to head injury. This is a rare case in which the patient had a history of head trauma due to road traffic accident with frontal contusion and small pneumocephalus, which was managed conservatively 2 years earlier followed by cerebrospinal fluid (CSF) rhinorrhea after 2 months, which was also managed by nonsurgical management. He presented with intractable seizures and features of raised intracranial pressure (ICP) with imaging suggestive of air-containing cavity in frontal region (pneumatocele). Intraoperatively, there was brain abscess with dural defect for which abscess was excised, and dural repair with exteriorization of frontal sinus was done.