Strange case of the man with a ‘large black hole’ in part of his brain

CT showing the osteoma (right) and a top-down MRI showing the affected brain area. Image credit: Lehmer et al./BMJ Case Reports

When an 84-year-old man in Ireland showed up at the doctor with complaints about being unsteady, the team found a strange reason for his new clumsiness. CT scans of the patient’s brain showed a large portion of his right frontal lobe appeared to be missing.

Because increased loss of balance and unilateral weakness presented together are often the sign of a stroke, the doctors sent the patient for a CT scan.

The result was baffling – a large black hole, nine centimetres (3.54 inches) across, where his right frontal lobe should be.

An MRI confirmed that the man’s brain matter wasn’t actually gone; rather, he had an air cavity inside his skull called a pneumatocoele.


The MRI also revealed the presence of an osteoma, a common type of benign bone tumour, on the man’s ethmoid bone, which separates the nasal cavity from the brain.

This eroded part of the bone, which in turn allowed air to be pushed into his skull under what the doctors called a “one-way valve effect.”


In the end, it also turned out that the doctors’ initial concerns were spot-on – because of the pressure on his brain, the patient did also have a minor stroke.

The doctors have published their paper in the journal BMJ Case Reports.

Read full, original post: This Man Had a Chunk of His Brain Go “Missing” For a Very Strange Reason

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