Large gaping hole discovered in Irish man's brain

MRI showing area of acute infarction or stroke

When the man added left-sided arm and leg weakness to the list of complaints, his doctor advised him to go to the emergency room, fearing a possible stroke.

Perhaps nothing too unusual for a man of his age, but further investigations revealed these symptoms were a red flag signaling much bigger problems. "He was a non-smoker and drank alcohol rarely". A blood test detected nothing abnormal. Other than the weakness, which lasted for three days, medical staff noted that he didn't have any confusion, facial weakness, vision or speech problems, and was otherwise reportedly feeling fine. He was otherwise fit and well, independent with physical activities of daily living (PADLs) and lived at home with his wife and two sons.

In other words, doctors thought, there was nothing apparent that would have suggested a clear reason for his symptoms.

Staff chose to give the man a CT and MRI scan, and it was then that they saw the blank where some of his brain should have been, measuring 3.5 inches long. Dr Finlay Brown, study co-author and physician at Causeway Hospital, told Newsweek.

"(We) were all very perplexed by the images we saw!" Instead, he received various types of medicines to help prevent future strokes, Brown told Live Science.

In fact they even wondered if the man had forgotten to disclose elements of his medical history. He said he had not. The emergence of air in a brain cranium following a major surgery is also commonly attributed to this condition.

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In this case, the patient's pneumatocele - or pressurised air cavity - measured about 3.5 inches at its longest, according to the BMJ Case Reports article.

An MRI would show the pneumatocele's likely cause was an osteoma, or benign bone tumour, that had formed in the man's sinus and was eroding through the base of the skull, Brown said.

He said it had likely been forming over months, even years. These air pockets are seen more commonly in patients who have facial trauma or infections, or who have had brain surgery, according to a report of the case, published February 27 in the journal BMJ Case Reports.

An 84-year-old man in Northern Ireland complaining of frequent falls and weakness on the left side of his body discovered that it was due to a massive air pocket that had filled the bulk of a section of his brain. However, due to the associated risks, the man declined the offer. When doctors were told that neither of these scenarios applied to the patient, they were "left very curious as to the cause of these findings", Brown said.

So far, though, the man appears to be doing well, despite the cranial air pocket.

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