A woman in her early 70s was in the shower when she blew her nose to relieve pressure and a crackling sensation in her left ear. When she was evaluated in an emergency department, her vital signs raised concern for dangerous pressure inside the skull, and a CT scan revealed extensive air around her brainstem.
The case appears in the October issue of The American Journal of Emergency Medicine and was first published online June 3. The authors, connected to Virginia Tech Carilion's Department of Emergency Medicine in Roanoke, Virginia, describe pneumocephalus, the presence of air inside the skull, after nose blowing. What sets their case apart is the route the air appears to have taken: through her ear.
