Naseem Eisa1, Hamzah Moh'd2, Abdul Hamid Alraiyes3, Khaldoon Shaheen4, Fayez Kheir3. 1. Department of Hospital Medicine, Medicine Institute, Cleveland Clinic, Cleveland, OH. 2. Division of Infectious Diseases, Department of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA. 3. Department of Pulmonary Diseases, Critical Care, and Environmental Medicine, Tulane University Health Sciences Center, New Orleans, LA. 4. Department of Hospital Medicine, Medicine Institute, Cleveland Clinic, Cleveland, OH ; Department of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH.
Abstract
BACKGROUND: Epidural pneumorrhachis (EPR), an extension of pneumomediastinum, results from air that leaks from the mediastinum and accumulates in the epidural space of the spine. It is an uncommon, benign condition; most cases are asymptomatic, are recognized only on computed tomography scans, and require no treatment. CASE REPORT: We present a case of EPR, pneumomediastinum, pneumothorax, and subcutaneous emphysema in a young male who was managed conservatively with supportive care. CONCLUSIONS: EPR is a rare yet benign condition that can be found incidentally while working up lung or spine pathology. Although radiography can define the presence of a pneumomediastinum and subcutaneous emphysema, the diagnosis of EPR can only be made using computed tomography. The management of EPR is usually conservative, and the focus should be on underlying disease.
BACKGROUND: Epidural pneumorrhachis (EPR), an extension of pneumomediastinum, results from air that leaks from the mediastinum and accumulates in the epidural space of the spine. It is an uncommon, benign condition; most cases are asymptomatic, are recognized only on computed tomography scans, and require no treatment. CASE REPORT: We present a case of EPR, pneumomediastinum, pneumothorax, and subcutaneous emphysema in a young male who was managed conservatively with supportive care. CONCLUSIONS: EPR is a rare yet benign condition that can be found incidentally while working up lung or spine pathology. Although radiography can define the presence of a pneumomediastinum and subcutaneous emphysema, the diagnosis of EPR can only be made using computed tomography. The management of EPR is usually conservative, and the focus should be on underlying disease.