Fallon M J, Plante D M, Brown L W
Ft. Richardson, Alaska.
J Emerg Med. 1992 Jul-Aug;10(4):439-43. doi: 10.1016/0736-4679(92)90273-v.
A 2 1/2-year-old child presented to the emergency department with a wooden stick lodged firmly in her right nares. No nasal discharge or neurological abnormalities were noted at presentation. After plain radiographs failed to demonstrate any evidence of a foreign body, computed tomography (CT scan) was obtained that revealed a hypodense region in the right frontal lobe corresponding to the projected tract of the branch. The patient underwent a right frontal craniotomy with debridement of her contused right frontal lobe. She was discharged 8 days postoperatively without evidence of neurologic sequelae. This case illustrates an unusual presentation of intracranial penetration, with only six similar cases found in the literature. It also highlights the need for the emergency physician to be concerned about intracranial penetration when treating intranasal foreign bodies, particularly those of the nonmetallic type. The literature is reviewed regarding transnasal intracranial penetration by wooden foreign bodies.
一名2岁半的儿童因一根木棍牢牢卡在右鼻孔而被送往急诊科。就诊时未发现鼻分泌物或神经异常。普通X光片未能显示任何异物迹象后，进行了计算机断层扫描（CT扫描），结果显示右额叶有一个低密度区域，与该树枝的预计路径相对应。患者接受了右额开颅手术，对挫伤的右额叶进行了清创。术后8天出院，无神经后遗症迹象。该病例说明了颅内穿透的一种不寻常表现，文献中仅发现6例类似病例。它还强调了急诊医生在处理鼻内异物，特别是非金属类型异物时，需要关注颅内穿透情况。本文回顾了关于木质异物经鼻颅内穿透的文献。
