Pneumocephalus with gas-fluid level

Discussion:

The patient was in a motor vehicle collision 15 years ago but did not attend hospital. During these years she did not undergo any imaging either. MRI examination showed a collection of gas and fluid in the right hemisphere, which is presumed to be a chronic process due to the absence of surrounding edema. The CT scan showed a fracture of the right ethmoid wall and the medial wall of the right orbit, which is the likely entry site of the gas. 

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