异物经颈静脉孔致非火器性颅脑穿通伤1例报告并文献复习

Penetrating brain injury through jugular foramen(a case report and literature review)

目的探讨异物经颈静脉孔致非火器性颅脑穿通伤(PBI)的诊断与治疗方式。方法回顾分析1例异物颈静脉孔刺入左侧小脑患儿的临床资料;并对相关文献进行复习。结果患儿女,3岁,进食时摔倒致筷子插入咽部,家人自行拔除大部分异物(不完整),伤后患儿出现咽痛、头痛、恶心、呕吐。颅脑CT、MRI、CTA检查示,左侧小脑局限水肿,筷子经口腔-左侧咽侧壁-颅底-颈静脉孔-左侧小脑。于全麻条件下经左侧乙状窦后入路开颅将异物完全取出。术后患者恢复良好,无发生颅内出血、感染等并发症及后遗症。结论对于经颈静脉孔致非火器类颅脑贯通伤患者,早期完善影像学检查,严谨手术操作,积极防治并发症,可显著改善患者的预后。

Objective To investigate the diagnosis and treatment of nonmissile penetrating brain injury(PBI)by the foreign body through the jugular foramen penetration.Methods The clinical data of a child with a foreign body inserted into the left cerebellum through jugular foramen were analyzed retrospectively,and the related literature was reviewed.Results A 3-year-old child,whose chopsticks were inserted into the pharynx due to falling while eating,had most of the foreign bodies removed by his family(incomplete).After the injury,the child developed a sore throat,headache,nausea and vomiting.Brain CT,MRI,CTA examination showed that the left cerebellum was localized edema,through the oral cavity-left pharyngeal wall-skull base-jugular foramen-left cerebellum.Under general anesthesia,the foreign body was removed completely through the left retrosigmoid approach.The patient recovered well without intracranial hemorrhage,infection,and other complications.Conclusion For nonmissile PBI by the foreign body through the jugular,perfect imaging examination in time and perfect surgical treatment can significantly improve the prognosis of these patients.