Kobayashi Sumio, Hongo Kazuhiro, Koyama Toru, Kobayashi Shigeaki
Department of Neurosurgery, lida Municipal, Hospital, lida, Matsumoto 390-8621, Japan.
J Clin Neurosci. 2004 Apr;11(3):322-4. doi: 10.1016/S0967-5868(03)00149-8.
A 24-year-old woman was struck on the head by a hammer. Because of early signs and symptoms of intercranial hypertension, she underwent surgery for elevation of the depressed fragments which was compressing the superior sagittal sinus (SSS). After operation, the intracranial pressure (ICP) once decreased, but it gradually increased again. After hypothermia and barbiturate therapy, she recovered fully except for partial visual field defect due to brain contusion. A carotid angiogram 28 days after injury revealed complete occlusion of the whole SSS with good collateral circulation. After brain edema had subsided, a follow-up angiogram revealed normal blood flow through the SSS. Elevation of depressed bony fragments is required for a case presenting with early signs and symptoms of intracranial hypertension due to sinus compression. In a case with severe destruction of the SSS, one needs to know that re-occlusion of the dural sinus may occur after surgical recanalisation.
一名24岁女性被锤子击中头部。由于出现颅内高压的早期体征和症状，她接受了手术，以抬起压迫上矢状窦（SSS）的凹陷骨折碎片。术后，颅内压（ICP）一度下降，但随后又逐渐升高。经过低温和巴比妥类药物治疗，她完全康复，仅因脑挫伤遗留部分视野缺损。受伤28天后的颈动脉血管造影显示整个SSS完全闭塞，但侧支循环良好。脑水肿消退后，随访血管造影显示通过SSS的血流正常。对于因窦受压而出现颅内高压早期体征和症状的病例，需要抬起凹陷的骨碎片。在SSS严重破坏的病例中，需要知道在手术再通后硬脑膜窦可能会再次闭塞。
