Middle aged female presented as a trauma patient after she was involved in a motor vehicle accident. The patient was ejected from the car and sustained a severe traumatic brain injury.

CT scan of her head revealed subdural hematoma, subarachnoid hemorrhage and intracerebral contusions. The presence of air within her cranium (pneumocephalus) was also noted (see image above with arrows pointing to the bubbles of gas).

The most common causes of pneumocephalus are neurosurgery and trauma. In this case the interruption of the dura and cranial bones lead to pneumocephalus.
The patient was taken to the operating room for subdural hematoma evacuation.