An 84-year-old man has declined surgery after a massive air-pocket was found in his brain.
The paper included gobsmacking medical scan images which show the 9cm air-filled pocket in his brain, revealing it was located in his right frontal lobe which controls muscle on the left side of the body.
He stayed in the hospital temporarily before being discharged but left doctors scratching their heads over one of the strangest cases they'd seen.
The missing white matter was particularly surprising because the man arrived in the emergency department with afflictions otherwise common for his age.
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He had reported feeling unsteady over the past several months, culminating in repeated falls in recent weeks. When the man added left-sided arm and leg weakness to the list of complaints, his doctor advised him to go to the emergency room, fearing a possible stroke. In the case report, doctors noted that: "There was no confusion, facial weakness, visual or speech disturbance..."
"He was otherwise fit and well, independent with physical activities of daily living. and lived at home with his wife and two sons". "He was a non-smoker and drank alcohol rarely".
Routine blood tests and regular health checks he undertook also failed to detect any sort of deformity, despite the huge hole inside his head.
A CT scan of the patient's brain, showing a large, black space in part of the brain, which is actually an air pocket or pneumatocele. Dr. Finlay Brown, co-author and physician at Causeway Hospital in Northern Ireland, told Newsweek via email.
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Although his blood work came back normal, brain imaging scans revealed a unusual, 3.5-inch pocket of air in his head. But the man had not.
It's cause was likely an osteoma, or benign bone tumour, something which had formed in the man's sinus, Brown said.
"From speaking to the specialists, it seems it has been progressing insidiously over months to years", Brown said. These air pockets are seen more commonly in patients who have facial trauma or infections, or who have had brain surgery, according to a report of the case, published February 27 in the journal BMJ Case Reports. For example, decompressing the brain area could have led to more problems, and the surgery might not have helped the patient's symptoms, Brown said. That could explain the small stroke that the man was found to have suffered and caused his left-side weakness.
Surgery is the most obvious treatment to remove the air pocket and to restore the man's brain cavity back to the correct shape.
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However The Washington Post reported that the man is doing well and has even reported he no longer feels any weakness.