Peer-reviewed veterinary case report
Pneumocephalus secondary to removal of an osteoma from the paranasal sinuses of a horse.
- Journal:
- Journal of the American Veterinary Medical Association
- Year:
- 2009
- Authors:
- Ragle, Claude A et al.
- Affiliation:
- Department of Veterinary Clinical Sciences · United States
- Species:
- horse
Plain-English summary
A 2-year-old Quarter Horse was seen because it had a growing deformity on the left side of its face and was having discharge from its left nostril and eye. The vet found that the left side of the horse's face was swollen, and tests showed a large mineralized mass in the left paranasal sinuses (the spaces around the nose). During surgery to remove the mass, they couldn't take it all out because it was stuck to the bones in the skull. After the surgery, the horse had a mild fever and some belly pain, and follow-up X-rays showed gas in the brain, which is a condition called pneumocephalus (air in the brain). Fortunately, the horse did not show any signs of neurological problems and was doing well two years later.
Abstract
CASE DESCRIPTION: A 2-year-old Quarter Horse was evaluated because of a progressive left-sided facial deformity and unilateral nasal and ocular discharge. CLINICAL FINDINGS: Physical examination revealed convexity of the left frontonasal region, left-sided nasal and ocular discharge, and decreased air flow through the left nares. Radiography and computed tomography revealed an extensively mineralized mass occupying most of the left paranasal sinuses. TREATMENT AND OUTCOME: The mass was surgically debulked, but complete removal was precluded because the mass was tightly adhered to the frontal and maxillary bones. Results of histologic examination of the mass were consistent with a diagnosis of osteoma. The horse developed transient pyrexia and colic following surgery, and postoperative radiography revealed gas opacities in the lateral ventricles of the brain, consistent with iatrogenic pneumocephalus. However, the horse did not develop any neurologic signs and was performing normally 2 years after surgery. CLINICAL RELEVANCE: Findings reinforce concerns that paranasal sinus surgery in horses can be associated with intracranial complications such as pneumocephalus. In horses with a mass involving the paranasal sinuses, computed tomography may be helpful in determining the boundaries of the mass and formulating a surgical treatment plan.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/19601740/