无脑实质出血颅骨骨折的损伤机制及其临床特点

Injury mechanism and its clinical characteristics of skull fracture without cerebral parenchyma bleeding

目的:探讨无脑实质出血颅骨骨折的损伤机制及其临床表现特点。方法:回顾性分析37例无脑实质异常的颅骨骨折患者的临床表现、治疗及影像学诊断表现,分析其创伤机制、并发症及预后。结果:37例患者CT或MRI检查均无脑实质出血表现,9例(24%)见少量蛛网膜下腔出血;31例(84%1)出现于60岁以上老年人。全部病例中颅骨凹陷性骨折19例,线性骨折18例,GCS评分均10～15分。全部病例无严重并发症。结论:无脑实质出血颅骨骨折主要见于老年人,因其颅骨含钙量少,蛛网膜下腔较大,轻度外力可使颅骨骨折而不致损伤脑实质,临床表现轻微,预后好。

Objective： To investigate injury mechanism and clinical charaeteristics of skull fracture without cerebral parenchyma trauma and bleeding. Methods： There were thirty- seven cases of skull fracture without cerebral parenchyma trauma in this artical. Their clinical characteristics, treatment and imaging features were reviewed. The mechanism, complication and prognosis of this trauma were analyzed retrospectively. Results： According to CT and MRI films, none of patients was found cerebral parenchyma hemorrhage. Nine cases（24% ） appeared a little subarachnoid hemorrhage nearby the fractured bone and 31 cases（84 % ） were the senile pa- tients, who were more than 60 years old. 19 cases of all patients showed impacted fracture and 18 cases showed linear fracture. Their grades were between 10 and 15 score. No severe complication was found in all patients. Conclusion： Skull fracture without cerebral parenchyma bleeding are mostly ,seen in old people. Because of little content of calcium and big cavity of subarachnoid, skull could be fractured easily by faint trauma without cerebral parenchyma injury. The clinical features are subtle and prognosis of this kind of fracture is good.