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Stunned Northern Ireland doctors discover air pocket in man's brain

By Rebecca Black

A Northern Ireland pensioner had been living with a 9cm sized air pocket in his brain before it was discovered when his GP referred him to the Causeway Hospital after he suffered multiple falls.

Medics were so intrigued by the strange case that they published a paper in the British Medical Journal's 'Case Reports' entitled 'The man that lost (part of) his mind'.

The patient - an unidentified 84-year-old man - had gone to his local GP after he had a number of falls and had been feeling unsteady on his feet for several months.

He went on to experience a feeling of weakness in his left arm and leg over three days.

However, the report said that he had suffered no confusion, facial weakness, visual or speech disturbance, and the man said that otherwise he was feeling well.

Routine blood tests also failed to detect any sort of abnormality, let alone the large hole inside the man's head.

The report said that the symptoms described were "relatively common in the elderly", but issued a warning to medics reading it that "rare causes must also be considered".

It was also noted in the BMJ report, which was authored by Dr Finlay Brown, that the patient was "otherwise fit and well", and had been living independently at home with his family.

The reports of weakness on his left hand side initially led to doctors suspecting a stroke.

But when the patient was referred to the Causeway Hospital by his GP, doctors were taken aback when they discovered the air pocket in his brain.

The paper includes remarkable medical scan images which show the 9cm air-filled pocket in his brain.

The CT scan showed it was located in his right frontal lobe - which controls muscle on the left side of the body.

Doctors initially believed the medical mystery was a pneumatocoele - an air-filled space.

The patient was then transferred to Antrim Area Hospital for an MRI scan of his head.

This confirmed it was an air pocket and also revealed a large osteoma - a benign, bone tumour. The air cavity had triggered an acute infarction - a blood flow blockage - to his corpus callosum, which connects the left part of the brain to the right.

The patient was put under observation, but turned down an offer of surgery, with the report noting that he had made "an informed decision ... given risks and benefits".

He stayed in hospital for a short time because of a lower respiratory tract infection, and was also started on secondary stroke prevention and advised by doctors to go back and see them if his symptoms worsened.

The patient was then discharged from hospital to return to life as normal, but left doctors continuing to puzzle over one of the most unusual cases they had seen in their careers.

Even more remarkably, 12 weeks later a follow up examination found that the left-sided weakness appeared to have resolved itself.

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