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Cranio-cervical bone hyperpneumatization: An overview and illustrative case
Authors: Mohammed Maan AbdulAzeez1? , Padilla-Zambrano Huber2 , Salima B. Alsaadi3 , Cabreras?Nanclares B. Vladimir2 , Luis Rafael Moscote Salazar4 , Samer S. Hoz5
Number of views: 324
The pneumatization of regions such as the apex of the temporal crag, the mastoid cells and
the perilaberytic region is considered physiological in adults. The process of craniocervical
pneumatization in unhealthy adults derives from a dysfunction at the level of the eustachian
tube, which provides a valve effect causing an increase in pressure at the level of the middle ear,
forcing the entry of air into the dome of the skull through the opening of the occipitomastoidal
suture. The process of standard pneumatization of the temporal bones, begins in the final
weeks preceding birth, characterized by a decrease in the embryonic mesenchyme at the
antrum level and progresses through childhood until adolescence, when the stone portion at the
level of the rock is pneumatized; Normal variants have been reported, such as pneumatization
that extends from the temporal scale to behind the sigmoid sinus. With regard to the process
of hyperneumatization, several etiologies have been proposed that a congenital process versus
an acquired process to develop this condition should be compared. The present illustrative
case is a seventy-three years old male presented to the outpatient clinic with chronic recurrent
occipital headache, already investigated by general practitioner for elevated blood pressure
which was excluded. We had checked him to exclude the cervical spinal origin of the occipital
headache which was then excluded too. This case scenario demonstrates the debate about how
to deal with such cases and thus the review will bring the attention of those who take care of
such radiological findings to keep in mind the possible causes and complications according to
the reported cases till now. We concluded that the hyperpneumatization of the craniocervical
junction is an uncommon radiological finding that is usually asymptomatic although it can
entail serious complications in some instances, especially when it enlarges progressively,
which may be due to an acquired process. Thus, craniocervical hyperpneumatization deserves
highlighting for the managing team to gain fluent treatment and better patient outcome.