An 84-year-old man in Ireland stunned doctors when scans revealed that he seemed to be missing a large chunk of his brain. The man came to the doctor's office about weakness on his left side and because he took many a tumble because of his unsteady walk.
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. "He was a non-smoker and drank alcohol rarely". A blood test detected nothing abnormal.
"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!"
Physician at Causeway Hospital, Finlay Brown, told the Washington Post that doctors were "perplexed" by the scans as the man had not had any surgery on his brain or defects at birth. When doctors were told that neither of these scenarios applied to the patient, they were "left very curious as to the cause of these findings", Brown said. "I wondered if the patient had previously undergone brain surgery or had a congenital abnormality we didn't know about". These air pockets are seen more commonly in patients who have facial trauma or infections, or who have had brain surgery, according to a report of the case, published February 27 in the journal BMJ Case Reports.More news: "Splinter Cell 2018" listed on Ubisoft's Amazon page
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 physicians at Causeway Hospital determined that the benign brain tumor formed in his sinuses and corroded part of his skull, which pushed air inside.
The MRI also revealed that the patient had experienced a small stroke related to the air pocket in his brain.
The doctors also noted that brain air pockets like this have, in rare cases, been reported to cause small strokes.More news: France's Macron pledges €700m to solar energy push
The patient needs two separate surgeries - one to get rid of the air pocket via decompression and another one to excise the bone tumor.
Brown told LiveScience he wanted to publish this case study to stress "the importance of thorough investigation of even the most common of symptoms", as an octogenarian's frequent falls and imbalance could have easily been written off.
His nonsurgical approach is not without risk: It's likely the patient will be at a greater risk for infection, since there remains a passageway for air - and therefore bacteria and viruses - into his brain cavity, Brown said.
"The left-sided weakness was noted to have resolved on follow-up 12 weeks later and he remained well", the authors conclude in the published report.More news: Cardinals free agent WR John Brown to sign with Ravens