# Frontal Sinus Osteoma Causing Tension Pneumocephalus and Acute Hemiparesis: A Rare Neurological Complication

## TL;DR

A rare case of a frontal sinus osteoma causing a life-threatening brain condition was successfully treated with surgery.

## Contribution

This case report highlights the rare neurological complication of tension pneumocephalus caused by a frontal sinus osteoma.

## Key findings

- A frontal sinus osteoma eroded the posterior sinus wall, leading to tension pneumocephalus and hemiparesis.
- Surgical excision and dural repair resolved symptoms and prevented recurrence.
- Early diagnosis and neuroimaging are critical for favorable outcomes in such cases.

## Abstract

Frontal sinus osteomas are typically benign and asymptomatic lesions. However, in rare instances, they can erode the posterior sinus wall, leading to tension pneumocephalus, a neurosurgical emergency. We report the case of a 33-year-old female presenting with progressive headache and right-sided hemiparesis. MRI and CT imaging revealed a large frontal sinus osteoma eroding the posterior table and resulting in tension pneumocephalus. The patient underwent frontal craniotomy, osteoma excision, dural repair, and sinus exteriorization. Postoperatively, her symptoms resolved completely, and follow-up imaging showed no recurrence. Tension pneumocephalus is a rare but serious complication of frontal sinus osteomas. Early diagnosis, combined with neuroimaging and surgical management, is essential for achieving favorable outcomes.