Computed tomography (CT) of head without contrast revealed cerebral atrophy, air in left cavernous sinus, right transverse foramen on C1 (A) which tracked down into venous circulation of neck (B) but no traumatic injury. Computed tomography (CT) of head without contrast revealed cerebral atrophy, air in left cavernous sinus, right transverse foramen on C1 (A) which tracked down into venous circulation of neck (B) but no traumatic injury BMJ Publishing Group Ltd J Investig Med 2018;66:354-554 Copyright © American Federation for Medical Research. All rights reserved.