Falls are a common problem among older adults, but for one 84-year-old man in Northern Ireland, a brain scan revealed a highly uncommon cause for his falls: A part of his brain appeared to be missing.
The man sought medical attention after several months of unsteady walking, multiple falls and weakness on his left side.
Perhaps nothing too unusual for a man of his age, but further investigations revealed these symptoms were a red flag signaling much bigger problems.
A CT scan revealed the pressurized air pocket where his right side of the brain should have been. "He was a non-smoker and drank alcohol rarely".
The BMJ report, which was authored by Dr. Finlay Brown, also said that the patient was "otherwise fit and well" and had been living relatively independently at home with his family.
Additionally, blood tests in the emergency department came back normal and he showed normal eye movement ranges, visual fields, speech, and swallowing.
"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!"
It turned out the man had pneumocephalus, or the presence of air in his cranium, a condition that is found in "nearly 100 per cent of cases after brain surgery", Brown said.
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But as with any surgery, there would be some risks for the patient.
"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 added.
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. Brown declared that his left-sided weakness was unrelated to the pneumocephalus but rather the side-effect of a minor brain stroke.
The man was offered operations in order to help remove the air pocket, however due to his health he is only taking medication for the issue instead.
Brown said he had never seen a case of brain pneumatocele tied to symptoms of falling, and he chose to publish this case to emphasize "the importance of thorough investigation of even the most common of symptoms", Brown said.
"Because every now and then, there will be a rare [or] unknown causation of these that could be overlooked", he told the science news site.
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.
Twelve weeks after his hospital stay, the patient remained well and no longer felt weakness on his left side, the report said.
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