Penetrating neck trauma causing tracheal rupture, spinal cord injury, and massive pneumocephalus.

We describe a case in which tracheal, esophageal, and spinal cord injuries associated with massive pneumocephalus were caused by a flying chainsaw segment. To our knowledge, this is the first such case reported in the medical literature. The management challenges inherent in this exceedingly rare combination of injuries are discussed, and a novel theory explaining the possible pathophysiological mechanism that led to pneumocephalus in our patient is put forth.