外伤后迟发性眶内脑膜脑膨出伴脑脊液鼻漏1例

Traumatic delayed intraorbital meningoencephalocele with cerebrospinal fluid rhinorrhea:a case report

目的探讨外伤后迟发性眶内脑膜脑膨出伴脑脊液鼻漏的临床表现、诊断及治疗方法。方法回顾性分析山西医科大学第一医院2019年8月收治的1例外伤后迟发性眶内脑膜脑膨出伴脑脊液鼻漏患者的临床资料,结合病史及影像学结果明确诊断后,遂在鼻内镜下行脑膜脑膨出修补术,术后给予降颅压、抗炎等治疗。结果患者术后半个月痊愈出院。术后1个月复查,患者头晕、头闷胀感明显好转,左眼球突出较术前缓解,双眼视力无明显变化。结论外伤后发现眶顶骨折缺损后,早期无眶内脑膜脑膨出者,应密切随访及定期复查CT、MRI,以便早发现早治疗。

Objective To investigate the clinical manifestations,diagnosis and treatment of delayed intraorbital meningoencephalocele with cerebrospinal fluid rhinorrhea after trauma.Methods A retrospective analysis was performed on the clinical data of an exceptional patient with delayed intraorbital meningoencephalocele with cerebrospinal fluid rhinorrhea after trauma admitted to the First Hospital of Shanxi Medical University in August 2019. After definite diagnosis based on medical history and imaging results, meningoencephalocele repair was performed under nasal endoscopy. After the operation, the patient was treated with cranial pressure reduction and anti-inflammatory.Results The patient recovered and left the hospital half a month after the operation. The patient’s dizziness and head bloating were significantly improved one month after the operation. The protrusion of left eye bulb was alleviated, which was compared with that before the operation. Binocular vision had no obvious change.Conclusion If there is no intraorbital meningoencephalocele in the early stage after traumatic orbital roof fracture, close follow-up and regular CT and MRI reexamination should be conducted for early detection and early treatment.