15 September 2026
: Case report 
A Case of Pneumocephalus on Valsalva Maneuver: A Case Report and Literature Review
Unusual clinical course
Bouchra Chergui EF 1, Julien Flament E 2, Nicolas Mulquin
B 3, Céline Couvreur E 1*
DOI: 10.12659/AJCR.953059
Am J Case Rep 2026; 27:e953059
Table 1 Reported cases of spontaneous pneumocephalus due to Valsalva maneuver.
| Authors (year) [Ref] | Etiology | Location | Symptoms | Location of air entry | Treatment |
|---|---|---|---|---|---|
| Maier (1996) []12 | Valsalva maneuver | Right parieto-temporo-occipital region, epidural | Headache, visual scotoma | Mastoid | Mastoidectomy seal |
| Babl (1999) []7 | Valsalva maneuver | Subarachnoid space | Headache | Sphenoid sinus | Surgery |
| Anorbe (2000) []19 | Valsalva maneuver | Right parieto-occipital region | Retroauricular swelling | Mastoid, petrous temporal bone | Surgical closure of the mastoid antrum |
| Schrijver (2003) []20 | Valsalva maneuver | Epidural | Asymptomatic | Mastoid | Conservative |
| Richards (2004) []10 | Coughing, sneezing, nose blowing | Extradural | Swelling in ear area, otalgia, cheek and jaw pain/paresthesia | Mastoid | Mastoidectomy seal |
| Tucker (2008) []21 | Nose blowing | Epidural | Headache, nausea | Mastoid | Surgery |
| Singh (2010) []22 | Valsalva maneuver | Left middle cranial fossa | Confusion | Tegmen tympani, temporal bone | Conservative |
| Mohammed (2011) []5 | Sneezing, nose blowing | Extradural | Headache | Temporal bone | Conservative |
| Rabello (2013) []23 | Valsalva maneuver | Extradural, parietal region | Aural fullness, nasal obstruction and pruritus, headache | Mastoid | Conservative |
| Mirone (2015) []24 | Nose blowing | Intraparenchymal, left frontal lobe | Loss of consciousness, hemiparesis, anosmia | Ethmoid sinus | Surgery |
| Pishbin (2015) []25 | Coughing | Intracranial, disseminated | Headache, nausea | Pneumosinus dilatans | Conservative |
| Baba (2016) []26 | Sneezing | Extra-axial, right cerebral hemisphere | Headache, rhinorrhea | Sphenoid sinus | Surgery |
| Wu (2018) []27 | Sneezing | Left occipital lobe | Headache, dizziness, epistaxis, tinnitus, otorrhea | Mastoid | Conservative |
| Boninsegna (2019) []28 | Nose blowing | Subdural and intraventricular | Headache | Cribriform plate | Surgery |