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Imaging characteristics and treatment strategies for carotid artery occlusion caused by skull base fracture:Three case reports 被引量:1
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作者 Pei-Xin Shangguan Ke-Chun Zhou 《World Journal of Clinical Cases》 SCIE 2024年第15期2664-2671,共8页
BACKGROUND Traumatic internal carotid artery(ICA)occlusion is a rare complication of skull base fractures,characterized by high mortality and disability rates,and poor prognosis.Therefore,timely discovery and correct ... BACKGROUND Traumatic internal carotid artery(ICA)occlusion is a rare complication of skull base fractures,characterized by high mortality and disability rates,and poor prognosis.Therefore,timely discovery and correct management are crucial for saving the lives of such patients and improving their prognosis.This article retrospectively analyzed the imaging and clinical data of three patients,to explore the imaging characteristics and treatment strategies for carotid artery occlusion,combined with severe skull base fractures.CASE SUMMARY This case included three patients,all male,aged 21,63,and 16 years.They underwent plain film skull computed tomography(CT)examination at the onset of their illnesses,which revealed fractures at the bases of their skulls.Ultimately,these cases were definitively diagnosed through CT angiography(CTA)examinations.The first patient did not receive surgical treatment,only anticoagulation therapy,and recovered smoothly with no residual limb dysfunction(Case 1).The other two patients both developed intracranial hypertension and underwent decompressive craniectomy.One of these patients had high intracranial pressure and significant brain swelling postoperatively,leading the family to choose to take him home(Case 2).The other patient also underwent decompressive craniectomy and recovered well postoperatively with only mild limb motor dysfunction(Case 3).We retrieved literature from PubMed on skull base fractures causing ICA occlusion to determine the imaging characteristics and treatment strategies for this type of disease.CONCLUSION For patients with cranial trauma combined with skull base fractures,it is essential to complete a CTA examination as soon as possible,to screen for blunt cerebrovascular injury. 展开更多
关键词 skull base fracture Traumatic internal carotid artery occlusion Blunt cerebrovascular injury Imaging Case report
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Imaging characteristics and treatment strategies for carotid artery occlusion caused by skull base fracture
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作者 Xue-Jian Wang 《World Journal of Clinical Cases》 SCIE 2024年第31期6513-6516,共4页
The internal carotid artery occlusion caused by head and neck trauma,also known as traumatic intracranial artery occlusion,is relatively rare clinically.Traumatic skull base fracture is a common complication of trauma... The internal carotid artery occlusion caused by head and neck trauma,also known as traumatic intracranial artery occlusion,is relatively rare clinically.Traumatic skull base fracture is a common complication of traumatic brain injury.Traumatic skull base fracture is one of the causes of traumatic internal carotid artery occlusion.If not detected early and treated in time,the prognosis of patients is poor.This editorial makes a relevant analysis of this disease. 展开更多
关键词 skull base fracture Traumatic internal carotid artery occlusion Blunt cerebrovascular injury IMAGING Imaging characteristics Treatment strategies
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Unusual Brain Trauma Injury
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作者 Diallo Moussa Traoré Youssouf +5 位作者 Kanikomo Drissa Diarra Sounkalo Izoudine B. Koumaré Sogoba Youssouf Sogoba Boubacar Diallo Oumar 《Open Journal of Modern Neurosurgery》 2024年第3期218-227,共10页
Unusual head trauma is rare with various mechanisms of occurrence. The injuries can be similar to those of road accidents but sometimes with significant complexities. The objective was to determine the frequency of th... Unusual head trauma is rare with various mechanisms of occurrence. The injuries can be similar to those of road accidents but sometimes with significant complexities. The objective was to determine the frequency of this pathology in our practice, describe the different mechanisms and report the craniocerebral lesions caused by this type of trauma. Materials and Method: This was a descriptive study with retrospective collection spread over a period of 3 years. After selecting the files, the patients and/or their companions were contacted by telephone to inquire about them and then returned to the consultation for reassessment. Disease history and information were obtained from patients’ medical records. Result: The frequency of this pathology was 1.78% and his incidence was 0.4 cases per month. The average age of the patients was 13.47 years. All the victims were male. 41.17% of patients were in school. The mechanisms of trauma were the hoof blow 47.1%, the horn blow 29.4% and the stone blow 11.7% respectively. 23.5% of patients were confused and 11.7% children were in coma. One patient presented an anisocoria. The motor deficit was present in 5 cases. CT-scan made it possible to highlight a skull depressing fracture 58.8% and confirm a craniocerebral wound in 35.3%. The average time between patient admission to hospital and completion of surgery was 24.5 hours. The surgery had consisted of the trimming of cranio-cerebral wounds, exploration, duroplasty and lifting of skull depressing fracture. After 15 months of follow-up, the evolution was favorable in 53.3%, the morbidity was 33.4% and the mortality 17.6%. Conclusion: These are rare but serious conditions because they are fatal and disabling. An early and multidisciplinary management can hope to have a good favorable. 展开更多
关键词 Brain Trauma Injury Insolite UNUSUAL skull Depressing Fracture Hoof Kick Horn Blows Stone Bows Motorcycle Gear Lever
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Successful management of depression skull fracture in a boy with dog bite injury:A case report
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作者 Abdulkerim Gokoglu Hasan Tahsin Gozdas +1 位作者 Selime Ozen Sonay Gokoglu 《Journal of Acute Disease》 2022年第5期202-205,共4页
Rationale:There are many cases of daily reported dog bite injuries around the world.However,craniofacial fractures owing to dog bites are quite rare.They are frequently seen in the pediatric age group.Here,we report t... Rationale:There are many cases of daily reported dog bite injuries around the world.However,craniofacial fractures owing to dog bites are quite rare.They are frequently seen in the pediatric age group.Here,we report the successful management of a pediatric patient with depression skull fracture due to a dog bite injury.Patient’s concerns:A 3-year-old boy was admitted to the emergency department with a complicated skull fracture due to a dog bite injury.In physical examination,the patient was neurologically intact.He had hemorrhagic scalp wounds.Cerebrospinal fluid was leaking on the right temporal and frontal sides.Diagnosis:Cranial computed tomography revealed pneumocephalus,brain edema,and compound fracture associated with right frontal concussion.Intervention:After decompressive craniectomy,duraplasty was performed by placing a galea graft.Depressed fractures were removed and subdural bleeding control was provided.Outcomes:Perioperative and postoperative periods were uneventful.Lessons:Emergency medicine physicians should control possible underlying fracture lines in pediatric head trauma caused by dog bites. 展开更多
关键词 Craniocerebral trauma Dog bite skull fracture Pediatric patient Cranial computed tomography Cerebrospinal fluid leakage
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Surgical Repair of Growing Skull Fracture: A Case Report
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作者 Youssouf Sogoba Seybou Hassane Diallo +7 位作者 Moussa Diallo Drissa Kanikomo Boubacar Sogoba Oumar Coulibaly Mahamadou Dama Mamadou Salia Diarra Oumar Diallo Youssoufa Maiga 《Case Reports in Clinical Medicine》 2022年第3期79-83,共5页
Background: Growing skull fractures (GSF) are a rare complication of pediatric head trauma that comprises post-traumatic skull defect associated with an underlying dural tear and an intact arachnoid membrane. They are... Background: Growing skull fractures (GSF) are a rare complication of pediatric head trauma that comprises post-traumatic skull defect associated with an underlying dural tear and an intact arachnoid membrane. They are often misdiagnosed, and delay in management can lead to progression of the disease with neurological sequelae. GSF are rare and their incidence has been estimated as 0.05% - 1% of all pediatric skull fractures. This low incidence and the subtlety of its presentation often make diagnosis challenging with consequent delay in management. Surgery is recommended to treat GSF and involved dural repair with or without cranioplasty. In this paper, we report a case of a patient with GSF in whom the surgical repair was successful with good cosmetic and functional outcome. Case Report: A 12 months old girl was admitted to our neurosurgical department with right parietal swelling that had been gradually enlarging over 3 months. The history of the disease began when the girl was 1 month old with a fall with cranial impact resulting in head trauma with initial loss of consciousness. At presentation the girl was alert with normal consciousness. Clinical examination revealed the deformed skull with large pulsatile and painless swelling lesion in the right parietal region and hemiparesis on the left side. The CT scan revealed type 3 GSF including parietal bone diastasis with hypodense fluid collection that mimicked the leptomeningeal and porencephalic cyst. Surgical repair was performed. The post-operative course was uneventful and the child was discharged home five days after surgical intervention. Conclusion: GSF can lead to serious neurologic complications. Therefore educating parents on this potential outcome and close follow-up with clinical and imaging screening is recommended to screen children at risk for the development of the disease. 展开更多
关键词 Growing skull Fracture Head Trauma Dural Tear
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Anticipation of Dural Tear in Patients with Blunt Head Trauma
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作者 Mohamed M. Elsherbini Ali H. Elmokadem +1 位作者 Hatem Badr Amr F. Khalil 《Open Journal of Modern Neurosurgery》 2022年第3期132-140,共9页
Background: Dural tears are considered among the neurosurgical challenges to be dealt with during management of head trauma patients;it’s important to anticipate such pathology pre-operatively;the purpose of this stu... Background: Dural tears are considered among the neurosurgical challenges to be dealt with during management of head trauma patients;it’s important to anticipate such pathology pre-operatively;the purpose of this study is to discuss and analyze various predictors of dural tear as a sequala of blunt head trauma. Methods: Patients with blunt head trauma who underwent surgery during the year 2020 were analyzed;operative data were reviewed;only patients with reported dural repair as a step during surgery were included. Patients with penetrating head injury were excluded. Preoperative radiology, epidemiological and clinical details were analyzed to conclude specific criteria for dural tear. Results: Twenty-three patients were involved in the study;male predominance was evident. The most common primary injury was depressed fracture (73.9%), while the most common mode of trauma was domestic injury (43.5%), especially in pediatric group (76.9%). Two cases of growing skull fracture were involved, and both were in pediatric group. CT findings were conclusive for immediate dural tear findings, however, suggestive for patients with growing skull fractures. Mean depth of depression for depressed fracture group was 15.07 mm. Conclusion: Dural tears are not a serious complication of head trauma, however, their sequalae are life-threatening. Anticipation of dural tear is feasible radiologically pre-operatively for immediate dural repair and craniotomy fashioning;for cases of growing skull fractures, it’s difficult to anticipate the course from time of impact till time of presentation. 展开更多
关键词 Dural Tear Growing skull Fracture Head Trauma Depressed Fracture
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A simple and successful treatment for rupture and defect of the posterior third superior sagittal sinus caused by open depressed skull fracture:A case report 被引量:1
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作者 Geng-Huan Wang He-Ping Shen +2 位作者 Zheng-Min Chu Jian-Guo Shen Jian Shen 《Chinese Journal of Traumatology》 CAS CSCD 2022年第2期115-117,共3页
It is extremely dangerous to treat the posterior third of the superior sagittal sinus (PTSSS) surgically, since it is usually not completely ligated. In this report, the authors described the case of a 27-year-old man... It is extremely dangerous to treat the posterior third of the superior sagittal sinus (PTSSS) surgically, since it is usually not completely ligated. In this report, the authors described the case of a 27-year-old man with a ruptured and defective PTSSS caused by an open depressed skull fracture, which was treated by ligation of the PTSSS and the patient achieved a positive recovery. The patient's occiput was hit by a height-limiting rod and was in a mild coma. A CT scan showed an open depressed skull fracture overlying the PTSSS and a diffuse brain swelling. He underwent emergency surgery. When the skull fragments were removed, a 4 cm segment of the superior sagittal sinus (SSS) and the adjacent dura mater were removed together with bone fragments. Haemorrhage occurred and blood pressure dropped. We completed the operation by ligating the severed ends of the fractured sagittal sinus. One month after the operation, apart from visual field defects, he recovered well. In our opinion, in primary hospitals, when patients with severely injured PTSSS cannot sustain a long-time and complicated operation, e.g., the bypass using venous graft, and face life-threatening conditions, ligation of the PTSSS is another option, which may unexpectedly achieve good results. 展开更多
关键词 Depressed skull fracture Superior sagittal sinus LIGATION Prognoses
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Temporal bone fracture and its complications 被引量:1
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作者 陈继川 姬长友 +1 位作者 杨成 刘兆华 《Chinese Journal of Traumatology》 CAS 2001年第2期106-109,共4页
Objective:: To explore the characteristics and treatment of temporal bone fractures and injuries in the medial-inner ear. Methods: The clinical data of 48 cases of temporal bone fractures admitted to our hospital from... Objective:: To explore the characteristics and treatment of temporal bone fractures and injuries in the medial-inner ear. Methods: The clinical data of 48 cases of temporal bone fractures admitted to our hospital from January 1989 to November 1999 were retrospectively analyzed. Results: Forty-eight patients with temporal bone fractures accounted for 17.00 % of the homochronous craniofacial fractures. Of the 48 cases, temporal bone fractures induced by traffic accidents accounted for 66.67 %, capillary fractures for 93.75 %, medial-inner ear injuries or craniocerebral injuries for 77.08 % and hearing loss or tinnitus for 48.00 %. The cerebrospinal fluid (CSF) otorrhea and facioplegia accounted for 36.70 % and 3.00 %, respectively, in the longitudinal fractures, while they were 25.00 % and 37.50 %, respectively, in the transversal fractures. Primary emergent operations were performed on 46 cases and neurosurgery accounted for 46.00 %. Secondary procedures accounted for 16.70 %. As a result, 43 cases survived ( 89.58 %) and 5 died ( 10.41 %). Conclusions: Traffic injury is the first high-dangerous factor for temporal bone fractures, which are often complicated with medial-inner ear or craniocerebral injury. The CSF otorrhea is common in the longitudinal fractures and facioplegia is common in the transversal fractures. The key step is to rescue the life, keep the airway unobstructed and maintain the circulation in the primary emergency treatment. 展开更多
关键词 skull fractures Wounds and injuries EAR
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Death due to fracture of thin calvarial hones after a fall: A forensic approach
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作者 Georgios Sioutas Maria-Valeria Karakasi +1 位作者 Stylianos Kapetanakis Pavlos Pavlidis 《Chinese Journal of Traumatology》 CAS CSCD 2017年第3期180-182,共3页
A 45-year-old male was autopsied. He had fallen backwards from a two-stairs height to the ground and passed away. A skull fracture was detected in the left occipital area, extending up to the left side of the skul! ba... A 45-year-old male was autopsied. He had fallen backwards from a two-stairs height to the ground and passed away. A skull fracture was detected in the left occipital area, extending up to the left side of the skul! base. The patient's death occurred due to the very low thickness of the calvarial bones, which led to the aforementioned fracture, and in turn resulted in subarachnoid hemorrhage and death. The cortical thickness was measured and compared with average values at standardized points. Uniform bone thinning was confirmed rather than localized. Calvarial thinning may result from various conditions. In the present case study, however, the exact mechanism which led to the low thickness of the calvarial bones of the patient is undetermined. Death due to the susceptible structure and fracture of calvarial bones has rarely been reported throughout relevant literature. 展开更多
关键词 Calvarial thinning Thin neurocranial bones skull fractures Cortical thickness Accidents Forensic pathology
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Long-term in vivo monitoring of injury induced brain regeneration of the adult zebrafish by using spectral domain optical coherence tomography 被引量:5
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作者 张建 张志伟 +1 位作者 葛伟 袁振 《Chinese Optics Letters》 SCIE EI CAS CSCD 2016年第8期81-84,共4页
Brain regenerative studies require precise visualization of the morphological structures. However, few imaging methods can effectively detect the adult zebrafish brain in real time with high resolution and good penetr... Brain regenerative studies require precise visualization of the morphological structures. However, few imaging methods can effectively detect the adult zebrafish brain in real time with high resolution and good penetration depth. Long-term in vivo monitoring of brain injuries and brain regeneration on adult zebrafish is achieved in this study by using 1325 nm spectral-domain optical coherence tomography(SD-OCT). The SD-OCT is able to noninvasively visualize the skull injury and brain lesion of adult zebrafish. Valuable phenomenon such as the fractured skull, swollen brain tissues, and part of the brain regeneration process can be conducted based on the SD-OCT images at different time points during a period of 43 days. 展开更多
关键词 regeneration coherence skull visualization fractured visualize penetration injured morphological reconstructed
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Brainstem auditory evoked potential combined with high resolution cranial base CT can optimize the diagnosis of auditory nerve injury 被引量:1
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作者 Hua Gu Xing-Ming Zhong +2 位作者 Yi-Qi Wang Jian-Guo Yang Yong Cai 《Chinese Journal of Traumatology》 CAS CSCD 2022年第3期156-160,共5页
Purpose:Auditory nerve injury is one of the most common nerve injury complications of skull base fractures.However,there is currently a lack of auxiliary examination methods for its direct diagnosis.The purpose of thi... Purpose:Auditory nerve injury is one of the most common nerve injury complications of skull base fractures.However,there is currently a lack of auxiliary examination methods for its direct diagnosis.The purpose of this study was to find a more efficient and accurate means of diagnosis for auditory nerve injury.Methods:Through retrospectively analyzing the results of brainstem auditory evoked potential(BAEP)and high-resolution CT(HRCT)in 37 patients with hearing impairment following trauma from January 1,2018 to July 31,2020,the role of the two inspection methods in the diagnosis of auditory nerve injury was studied.Inclusion criteria were patient had a clear history of trauma and unilateral hearing impairment after trauma;while exclusion criteria were:(1)severe patient with a Glasgow coma scale score<5 because these patients were classified as severe head injury and admitted to the intensive care unit,(2)patient in the subacute stage admitted 72 h after trauma,and(3)patient with prior hearing impairment before trauma.According to Goodman's classification of hearing impairment,the patients were divided into low/medium/severe injury groups.In addition,patients were divided into HRCT-positive and negative groups for further investigation with their BAEP results.The positive rates of BEAP for each group were observed,and the results were analyzed by Chi-square test(p<0.05,regarded as statistical difference).Results:A total of 37 patients were included,including 21 males and 16 females.All of them were hospitalized patients with GCS score of 6-15 at the time of admission.The BAEP positive rate in the medium and severe injury group was 100%,which was significantly higher than that in the low injury group(27.27%)(p<0.01).The rate of BEAP positivity was significantly higher in the HRCT-positive group(20/30,66.7%)than in the HRCT-negative group(1/7,14.3%)(p<0.05).Twenty patients(54.05%)were both positive for BEAP and HRCT test,and considered to have auditory nerve damage.Six patients(16.22%)were both negative for BEAP and HRCT test,and 10 patients(27.03%)were BAEP-negative but HRCT-positive:all the 16 patients were considered as non-neurological injury.The rest 1 case(2.70%)was BAEP-positive but HRCT-negative,which we speculate may have auditory nerve concussion.Conclusion:By way of BAEP combining with skull base HRCT,we may improve the accuracy of the diagnosis of auditory nerve injury.Such a diagnostic strategy may be beneficial to guiding treatment plans and evaluating prognosis. 展开更多
关键词 Auditory nerve injury skull base fracture Brainstem auditory evoked potential(BAEP) High-resolution CT(HRCT)
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Rational design of secondary operation for penetrating head injury:A case report
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作者 Yi-Kai Yuan Tong Sun +3 位作者 Yi-Cheng Zhou Xue-Pei Li Hang Yu Jun-Wen Guan 《Chinese Journal of Traumatology》 CAS CSCD 2020年第2期84-88,共5页
Penetrating head injury is rare,and thus management of such injuries is non-standard.Early diagnosis and intraoperative comprehensive exploration are necessary considering the complexity and severity of the trauma.How... Penetrating head injury is rare,and thus management of such injuries is non-standard.Early diagnosis and intraoperative comprehensive exploration are necessary considering the complexity and severity of the trauma.However,because of the lack of microsurgical techniques in local hospitals,the possible retained foreign bodies and other postoperative complications such as cerebrospinal fluid(CSF)leak usually require a rational design for a secondary operation to deal with.We present a case of a 15-year-old boy who was stabbed with a bamboo stick in his left eye.The chopsticks passed through the orbit roof and penetrated the skull base.In subsequent days,the patient sustained CSF leak and intracranial infection after an unsatisfied primary treatment in the local hospital and had to request a secondary operation in our department.Computed tomography including plain scan,three dimension recon-struction and computed tomographic angiography are used to determine the course and extent of head injury.A frontal craniotomy was performed.Three pieces of stick were found residual and removed with the comminuted orbit bone fragments.A pedicled temporalis muscle fascia graft was applied to repair the frontier skull base and a free temporalis muscle flap to seal the frontal sinus defect.Aggressive broad-spectrum antibiotics of vancomycin and meropenem were administrated for persistent fever after operation.CSF external drainage system continued for 12 days,and was removed 10 days after tem-perature returned to normal.The Glasgow coma scale score was improved to 15 at postoperative day 7 and the patient was discharged at day 22 uneventfully.We believe that appropriate preoperative surgical plan and thorough surgical exploration by microsurgery is essential for attaining a favorable outcome,especially in secondary operation.Good postoperative recovery depends on successfully management before and after operation for possible complications as well. 展开更多
关键词 Rational design Secondary operation Penetrating head injury skull base fracture
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