The man sought medical attention after several months of unsteady walking, multiple falls and weakness on his left side.
Although it is common for elderly people to occasionally fall down, the 84-year-old reportedly did not display other life-threatening issues such as slurred speech or confusion, according to a report about the case published by the British Medical Journal Case Reports.
Perhaps nothing too unusual for a man of his age, but further investigations revealed these symptoms were a red flag signaling much bigger problems. When the results from the CT scan came out, the doctors saw a 3-inch air pocket in his right frontal lobe. He didn't smoke. He rarely drank.
"He was otherwise fit and well, independent with physical activities of daily living. and lived at home with his wife and two sons". A blood test detected nothing abnormal.
Finlay Brown, a physician working in the emergency department at Causeway Hospital in Coleraine, Northern Ireland, at the time, remembers reviewing the brain-imaging scans with the rest of the staff.
"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!"
The scans were so extreme, doctors wondered if the man had forgotten to disclose previous brain surgery or birth defects. The emergence of air in a brain cranium following a major surgery is also commonly attributed to this condition.
"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.
In the patient's case, the condition was facilitated by an osteotoma, a benign bone tumor, which erodes his sinuses.
The MRI also revealed that the patient had experienced a small stroke related to the air pocket in his brain.
His left-sided weakness was likely caused by a small stroke - a "rare" side effect of having an air cavity in the brain.
Doctors told the man that they could perform brain surgery to release the air from the cavity, which would allow his brain to resume its normal shape, as well as a separate surgery to remove the osteoma. For example, decompressing the brain area could have led to more problems, and the surgery might not have helped the patient's symptoms, Brown said.
So far, though, the man appears to be doing well, despite the cranial air pocket.
Brown and his coauthors, however, stressed in their paper that symptoms like this patient's should always be thoroughly explored.
"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.
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