Abstract: Researchers report a case of pneumocephalus secondary to pneumomediastinum and pneumothorax and subcutaneous emphysema as a result of car accident. About 55 years old man with a head and neck trauma and right upper limb paralysis shown to the emergency department without any evidence of skull fracture. About 8 days later he developed symptoms of neurologic deterioration. Multislice CT scanning of the head showed extensive pneumocephalus adjacent to right. Frontal lob with pressure effect on underlying brain parenchyma and shift of brain, ventricles and midline structures toward left side spiral lung CT scan showed penumomedistinum, extensive subcutaneous emphysema in the Right hemi thorax, mild pneumothorax and irregularity in the first rib in right side. After 2 weeks of follow-up, with conservative treatment, the intracranial air resolved spontaneously and the patient completely recovered.