Study Design. This is a case report. Objective. A case of intraspinal
air in a polytraumatized patient with unrecognized pneumothorax after
blunt chest trauma is reported. Summary of Background Datal. In most c
ases, intraspinal air is associated with degenerative disc disease, ep
idural abscess, or synovial cyst, or it follows iatrogenic manipulatio
n. Scialdone and Wagle first reported a case of intraspinal air due to
a laceration of the right main bronchus. No previous case of intraspi
nal air after a simple unsuspected pneumothorax fol- towing blunt ches
t trauma has been reported. Methods. During routine x-ray and computed
tomography examination of a polytraumatized patient, an unsuspected p
neumothorax due to a rib fracture was detected in a thorax computed to
mography scan. Computed tomography scans of the cervical spine showed
a collection of intraspinal air. Results. The computed tomography exam
ination of a polytraumtized patient with an unsuspected pneumothorax a
fter blunt chest trauma showed the embolization of air in the paravert
ebral vein plexus and in the intraspinal canal. Conclusion. These obse
rvations suggest a wider indication for computed tomography scans of t
he thorax in blunt chest trauma. Also, whenever intraspinal air is fou
nd in the diagnostic course of a traumatized patient, a hidden pneumot
horax should be suspected and ruled out.