Pneumocephalus is defined as the presence of air or gas within the cranial cavity. It is usually associated with disruption of the continuity of the skull after head and facial trauma, neuro or otorhinolaryngologic surgery, and rarely, spontaneously. But a case of pneumo-hydrocephlus, a special subtype of pneumocephalus, has been rarely reported. This is a case of a 26-year-old quadriplegic patient who traumatic brain injury with left frontoparietal skull bone fracture and epidural hemorrhage with developed of pneumo-hydrocepahlus in the ventricle 6 months after injury. The mechanism of this case can be explained by the "inverted bottle" hypothesis. Clinical observation suggests that the leakage of cerebrospinal fluid through the ventricle-peritoneal shunt tube caused negative pressure gradient differences resulting in the inflow of outside air into the ventricle through fissures created by concealed fracture of the skull base.
Adult ; Brain Injuries ; Fractures, Bone ; Head ; Hemorrhage ; Humans ; Pneumocephalus ; Skull ; Skull Base ; Ventriculoperitoneal Shunt

Scabies is a skin disease caused by the parasite Sarcoptes scabiei var. hominis, primarily transmitted via direct skin or sexual contact or, less commonly, via contact with infested fomites. In Korea, the incidence of scabies has decreased from approximately 50,000 people/yr in 2010 to approximately 30,000 people/yr in 2021. However, outbreaks have been consistently observed in residential facilities, such as nursing facilities, particularly among the older population. The clinical manifestations of scabies vary depending on a patient’s age, health status, number of mites, and transmission route. Typical clinical presentations of classic scabies include intense nocturnal pruritus and characteristic skin rashes (burrows and erythematous papules), with a predilection for the interdigital web spaces, inner wrists, periumbilical areas, axillae, and genital areas. Unlike classic scabies, older adults with immunodeficiency or neurological disorders exhibit hyperkeratotic scaly lesions or an atypical distribution with mild-to-non pruritus (crusted scabies). Diagnosis of scabies is based on clinical symptoms and results of diagnostic tests aimed at identifying the presence of the parasite. Although a close contact history and characteristic clinical findings are suggestive of scabies, confirmation of diagnosis requires detection of scabies mites, eggs, or scybala.This can be achieved through light microscopy of skin samples, non-invasive dermoscopy, and other high-resolution in vivo imaging techniques.

For all suspected, clinical, or confirmed cases of scabies, treatment should be initiated. Affected patients should be adequately isolated, and high-risk groups with close contact histories should be treated irrespective of their symptoms. Optimal treatment strategies can be selected based on age, clinical subtype, and patient’s health status. In Korea, commercially available preparations for scabies treatment include topical 5% permethrin, topical 10% crotamiton, and oral ivermectin. Topical 5% permethrin is the first-line selective treatment for both classic and crusted scabies. Alternative treatments are topical 10% crotamiton and oral ivermectin. Following treatment completion, a follow-up visit at 2 and 4 weeks is recommended to monitor therapeutic response. Treatment failure is considered when scabies mites or burrows are detected, upon development of new clinical characteristics, or upon aggravation of pruritus. Scabies itch should be adequately managed with emollients, oral antihistamines, and topical corticosteroids. Preventive measures, including personal hygiene, patient education, and environmental control should be rendered to reduce the transmission of scabies.

Treatment should be initiated for all suspected, clinical, or confirmed cases of scabies. Patients affected should be adequately isolated, and high-risk groups with close contact histories should be treated regardless of their symptoms. Optimal treatment strategies can be selected based on age, clinical subtype, and the patient's health status. In Korea, commercially available preparations for scabies treatment include topical 5% permethrin, topical 10% crotamiton, and oral ivermectin. Topical 5% permethrin is the first-line selective treatment for both classic and crusted scabies. Alternative treatments include topical 10% crotamiton and oral ivermectin. After completing treatment, followup visits at 2 and 4 weeks are recommended to monitor the therapeutic response. Treatment is considered to have failed if scabies mites or burrows are detected, new clinical characteristics develop, or there is an aggravation of pruritus. Scabies itch should be adequately managed with emollients, oral antihistamines, and topical corticosteroids. Preventive measures, including personal hygiene, patient education, and environmental control, should be implemented to reduce the transmission of scabies.

Scabies is a skin disease caused by the parasite Sarcoptes scabiei var. hominis, which is primarily transmitted via direct skin or sexual contact or, less commonly, via contact with infested fomites. In Korea, the incidence of scabies has decreased from approximately 50,000 cases per year in 2010 to about 30,000 cases per year in 2021. However, outbreaks are consistently observed in residential facilities, such as nursing homes, especially among older adults. The clinical manifestations of scabies vary based on the patient’s age, health status, the number of mites, and the route of transmission.Typical symptoms of classic scabies include intense nocturnal itching and characteristic skin rashes (burrows and erythematous papules), with a predilection for the interdigital web spaces, inner wrists, periumbilical areas, axillae, and genital areas. In contrast, older adults with immunodeficiency or neurological disorders may exhibit hyperkeratotic scaly lesions or an atypical distribution with mild to no itching (crusted scabies). The diagnosis of scabies is based on clinical symptoms and the results of diagnostic tests aimed at identifying the presence of the parasite. While a history of close contact and characteristic clinical findings suggest scabies, confirmation of the diagnosis requires detecting scabies mites, eggs, or scybala. This can be achieved through light microscopy of skin samples, noninvasive dermoscopy, and other high-resolution in vivo imaging techniques.

Treatment should be initiated for all suspected, clinical, or confirmed cases of scabies. Patients affected should be adequately isolated, and high-risk groups with close contact histories should be treated regardless of their symptoms. Optimal treatment strategies can be selected based on age, clinical subtype, and the patient's health status. In Korea, commercially available preparations for scabies treatment include topical 5% permethrin, topical 10% crotamiton, and oral ivermectin. Topical 5% permethrin is the first-line selective treatment for both classic and crusted scabies. Alternative treatments include topical 10% crotamiton and oral ivermectin. After completing treatment, followup visits at 2 and 4 weeks are recommended to monitor the therapeutic response. Treatment is considered to have failed if scabies mites or burrows are detected, new clinical characteristics develop, or there is an aggravation of pruritus. Scabies itch should be adequately managed with emollients, oral antihistamines, and topical corticosteroids. Preventive measures, including personal hygiene, patient education, and environmental control, should be implemented to reduce the transmission of scabies.

Scabies is a skin disease caused by the parasite Sarcoptes scabiei var. hominis, which is primarily transmitted via direct skin or sexual contact or, less commonly, via contact with infested fomites. In Korea, the incidence of scabies has decreased from approximately 50,000 cases per year in 2010 to about 30,000 cases per year in 2021. However, outbreaks are consistently observed in residential facilities, such as nursing homes, especially among older adults. The clinical manifestations of scabies vary based on the patient’s age, health status, the number of mites, and the route of transmission.Typical symptoms of classic scabies include intense nocturnal itching and characteristic skin rashes (burrows and erythematous papules), with a predilection for the interdigital web spaces, inner wrists, periumbilical areas, axillae, and genital areas. In contrast, older adults with immunodeficiency or neurological disorders may exhibit hyperkeratotic scaly lesions or an atypical distribution with mild to no itching (crusted scabies). The diagnosis of scabies is based on clinical symptoms and the results of diagnostic tests aimed at identifying the presence of the parasite. While a history of close contact and characteristic clinical findings suggest scabies, confirmation of the diagnosis requires detecting scabies mites, eggs, or scybala. This can be achieved through light microscopy of skin samples, noninvasive dermoscopy, and other high-resolution in vivo imaging techniques.

Treatment should be initiated for all suspected, clinical, or confirmed cases of scabies. Patients affected should be adequately isolated, and high-risk groups with close contact histories should be treated regardless of their symptoms. Optimal treatment strategies can be selected based on age, clinical subtype, and the patient's health status. In Korea, commercially available preparations for scabies treatment include topical 5% permethrin, topical 10% crotamiton, and oral ivermectin. Topical 5% permethrin is the first-line selective treatment for both classic and crusted scabies. Alternative treatments include topical 10% crotamiton and oral ivermectin. After completing treatment, followup visits at 2 and 4 weeks are recommended to monitor the therapeutic response. Treatment is considered to have failed if scabies mites or burrows are detected, new clinical characteristics develop, or there is an aggravation of pruritus. Scabies itch should be adequately managed with emollients, oral antihistamines, and topical corticosteroids. Preventive measures, including personal hygiene, patient education, and environmental control, should be implemented to reduce the transmission of scabies.

Scabies is a skin disease caused by the parasite Sarcoptes scabiei var. hominis, which is primarily transmitted via direct skin or sexual contact or, less commonly, via contact with infested fomites. In Korea, the incidence of scabies has decreased from approximately 50,000 cases per year in 2010 to about 30,000 cases per year in 2021. However, outbreaks are consistently observed in residential facilities, such as nursing homes, especially among older adults. The clinical manifestations of scabies vary based on the patient’s age, health status, the number of mites, and the route of transmission.Typical symptoms of classic scabies include intense nocturnal itching and characteristic skin rashes (burrows and erythematous papules), with a predilection for the interdigital web spaces, inner wrists, periumbilical areas, axillae, and genital areas. In contrast, older adults with immunodeficiency or neurological disorders may exhibit hyperkeratotic scaly lesions or an atypical distribution with mild to no itching (crusted scabies). The diagnosis of scabies is based on clinical symptoms and the results of diagnostic tests aimed at identifying the presence of the parasite. While a history of close contact and characteristic clinical findings suggest scabies, confirmation of the diagnosis requires detecting scabies mites, eggs, or scybala. This can be achieved through light microscopy of skin samples, noninvasive dermoscopy, and other high-resolution in vivo imaging techniques.

Treatment should be initiated for all suspected, clinical, or confirmed cases of scabies. Patients affected should be adequately isolated, and high-risk groups with close contact histories should be treated regardless of their symptoms. Optimal treatment strategies can be selected based on age, clinical subtype, and the patient's health status. In Korea, commercially available preparations for scabies treatment include topical 5% permethrin, topical 10% crotamiton, and oral ivermectin. Topical 5% permethrin is the first-line selective treatment for both classic and crusted scabies. Alternative treatments include topical 10% crotamiton and oral ivermectin. After completing treatment, followup visits at 2 and 4 weeks are recommended to monitor the therapeutic response. Treatment is considered to have failed if scabies mites or burrows are detected, new clinical characteristics develop, or there is an aggravation of pruritus. Scabies itch should be adequately managed with emollients, oral antihistamines, and topical corticosteroids. Preventive measures, including personal hygiene, patient education, and environmental control, should be implemented to reduce the transmission of scabies.