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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