A 64-year-old man was admitted with swelling in the right periorbital area and right face and conjunctival hemorrhage with blurred vision in the right eye (
Fig. 1), which had been exposed to a compressed air gun. Physical examination revealed conjunctival laceration, iritis, and corneal erosion in the right eye, a deep laceration of the right medial canthus, and right lacrimal canaliculi division. Computed tomography (CT) scan of the brain and facial bone showed extensive subcutaneous emphysema in the right periorbital area, which spread to the right temporal, retrobulbar, masseter, buccal, parapharyngeal, submandibular, and left periorbital areas, and disseminated pneumocephalus was noted in the subarachnoid space of the skull base without fracture of the facial bone and skull (
Fig. 2.). There was no neurologic symptom or sign caused by the pneumocephalus. Lacrimal duct reconstruction for the right lacrimal canaliculus injury was performed on hospital day 2. A broadspcetrum antibiotic was applied for the pneumocephalus. Follow-up CT scan of the brain on hospital day 6 showed complete resolution of pneumocephalus and markedly decreased emphysema in the right face. The patient was discharged on hospital day 9 with improving blurred vision.