Scary gas: intravascular, intracranial, and intraspinal ectopic gas (part III).
Emerg Radiol. 2017 Aug;24(4):411-416. doi: 10.1007/s10140-017-1492-8. Epub 2017 Mar 2. Sandstrom CK1, Osman SF2, Linnau KF3.
While ectopic gas can be a sign of dangerous disease requiring immediate medical or surgical intervention, it can also be an incidental and benign finding. Intravenous gas and spinal vacuum gas are common and almost always benign. Intravascular gas is most often related to instrumentation and, if intraarticular, can cause end-organ ischemia; however, treatment is usually supportive. Pneumocephalus arises from a communication with paranasal sinuses or mastoids more often than from meningeal infection and can usually be managed nonoperatively. In part 3 of this series, the different causes of ectopic gas in the vessels, skull, and spine are reviewed, as are the imaging features that can help to narrow the differential diagnosis.