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Case Reports
. 2005 May;26(5):1218-9.

Barotrauma presenting as temporal lobe injury secondary to temporal bone rupture

Maria D P Cortes  1 , Neil S Longridge, Michael Lepawsky, Robert A Nugent
Affiliations
Case Reports

Barotrauma presenting as temporal lobe injury secondary to temporal bone rupture

Maria D P Cortes et al. AJNR Am J Neuroradiol. 2005 May.

Abstract

We present the case of a scuba diver who experienced acute ear pain during ascent from a dive. CT imaging was performed because of severe unrelenting headache. Blood and gas was identified within the epidural space of the middle fossa and over the petrous bone, as well as hemorrhage within the adjacent temporal lobe. To the best of our knowledge, this is the first case of CT-documented barotrauma affecting the brain as a result of middle-ear gas rupturing through the tegmen tympani.

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Figures

F<sc>ig</sc> 1.
Fig 1.
Noncontrast axial CT obtained at time of initial presentation in emergency. Sections obtained at the level of the petrous bone (A), immediately above the petrous bone (B), and more superiorly through the temporal lobe (C) demonstrate epidural blood and gas in the left middle fossa as well as parenchymal blood (B and C, arrows) in the temporal lobe immediately above the petrous bone.
F<sc>ig</sc> 2.
Fig 2.
A, High-resolution CT of the left temporal bone obtained 15 hours after the initial CT. Axial (A) and coronal (B and C) views show subtle opacification of mastoid cells and intracranial air within the middle fossa. Middle-ear cavity is normal, but gas is present immediately above the tegmen tympani (C, arrow). No disruption can be identified but bone could not be clearly identified along the entire tegmen tympani (other images not included).
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