Subcutaneous and Orbital Emphysema With Pneumocephalus Secondary to Compressed-Air Gun Injury to the Face.
Fatih Çalış, Naci Balak
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Case in brief
A healthy 26-year-old man presented with right periorbital swelling and headache after compressed air struck his face while he was cleaning work clothes with an air gun. Evaluation showed subcutaneous and orbital emphysema and pneumocephalus. No skull, facial, or orbital fractures were detected, and examination found no obvious entry site or conjunctival tear. The report describes the injury and its associated air in these compartments; the precise route of entry could not be determined.
What made this case unusual
Air reached the orbital and intracranial compartments despite no detected fractures or obvious conjunctival tear, and no entry site was identified.
Diagnostic / clinical pearl
After facial exposure to a compressed-air gun, consider orbital and periorbital emphysema and pneumocephalus even when routine imaging shows no fractures and eye examination reveals no conjunctival tear.