Pneumocephalus is most frequently caused by head trauma, especially to the paranasal sinuses and mastoid areas. Tumours of the skull base, such as osteoma or pituitary tumour, are less common causes. Since osteoma is one of the more common benign tumours of the nose and paranasal area with the frontal sinus being its most frequent location, special attention should be paid to the examination of this area for frontal osteoma in patients presenting with spontaneous pneumocephalus.

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