The pressure associated with a forceful blowing of the nose may be high enough to cause pneumocephalus.
Possible mechanisms:
(1) skull base dehiscence with dural rupture
(2) damage the cribriform plate
Clinical features:
(1) a recent history of a forceful blowing of the nose
(2) the onset of a severe headache and/or confusion
(3) the presence of CSF rhinorrhea (nasal drainage of a clear fluid)
On imaging studies air can be seen in the CNS.
The association with nose-blowing requires exclusion of other causes of pneumocephalus.
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Specialty: Otolaryngology, Neurology
