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Case Reports in Oncological Medicine
Volume 2014, Article ID 327380, 4 pages
http://dx.doi.org/10.1155/2014/327380
Case Report

Tension Pneumocephalus Related to Radiotherapy for Nasopharyngeal Carcinoma

1Radiation Oncology Department, Hospital Universitari Son Espases de Palma de Mallorca, Palma Health Research Institute (IdIsPa), 07005 Palma de Mallorca, Spain
2Radiation Oncology Department, Complejo Hospitalario Universitario de Albacete, 02006 Albacete, Spain

Received 8 March 2014; Revised 10 July 2014; Accepted 24 July 2014; Published 14 August 2014

Academic Editor: Yi-Jen Chen

Copyright © 2014 Esther Jimenez-Jimenez et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Tension pneumocephalus (TP) is a very rare complication related to radiotherapy for nasopharyngeal carcinoma (NPC). Case Presentation. A 46-year-old man was admitted to the hospital with an altered mental status and aqueous rhinorrhea for several hours of evolution. The computed tomography (CT) scan showed TP, a defect in the skull base and nasocranial fistula. The patient was receiving a second course of radiotherapy for local relapse. With medical treatment the patient recovered neurological status but died two days later. Discussion. In our knowledge, only 4 cases with similar characteristics have been reported in the literature. This is the first case report of TP during radiotherapy. TP was an abrupt and rapid process with neurological impairment for hours of evolution without suspicious osteoradionecrosis (OR) in previous scan images. The defect in the skull base could be due to a rapid disappearance of the tumor. The appearance of aqueous rhinorrhea and neurological symptoms must be viewed as signs of alarm.