Syed Omar N, Hankinson Todd C, Mack William J, Feldstein Neil A, Anderson Richard C E
Department of Neurological Surgery, New York Presbyterian Hospital, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
J Neurosurg Pediatr. 2008 Dec;2(6):424-6. doi: 10.3171/PED.2008.2.12.424.
Pediatric neurosurgeons frequently care for children with traumatic scalp and skull injury. Foreign objects are often observed on imaging and may influence the clinician's decision-making process. The authors report on 2 cases of poorly visualized hair beads that had become embedded into the skull during blunt trauma. In both cases, skull radiography and CT scanning demonstrated depressed, comminuted fractures with poorly demonstrated spherical radiolucencies in the overlying scalp. The nature of these objects was initially unclear, and they could have represented air that entered the scalp during trauma. In one case, scalp inspection demonstrated no evidence of the bead. In the other case, a second bead was observed at the site of scalp laceration. In both cases, the beads were surgically removed, the fractures were elevated, and the patients recovered uneventfully. Radiolucent fashion accessories, such as hair beads, may be difficult to appreciate on clinical examination and may masquerade as clinically insignificant air following cranial trauma. If they are not removed, these foreign bodies may pose the risk of an infection. Pediatric neurosurgeons should consider hair accessories in the differential diagnosis of foreign bodies that may produce skull fracture following blunt trauma.
小儿神经外科医生经常诊治患有外伤性头皮和颅骨损伤的儿童。影像学检查时经常会发现异物，这些异物可能会影响临床医生的决策过程。作者报告了2例钝器伤时嵌入颅骨的不易看清的发珠病例。在这两例病例中，颅骨X线摄影和CT扫描均显示凹陷性粉碎性骨折，头皮上方有显示不清的球形透光区。这些物体的性质起初并不明确，它们可能是外伤时进入头皮的空气。在1例病例中，头皮检查未发现珠子的迹象。在另一例病例中，在头皮裂伤处发现了第二颗珠子。在这两例病例中，珠子均通过手术取出，骨折复位，患者顺利康复。透光的时尚饰品，如发珠，在临床检查时可能难以察觉，在颅脑外伤后可能会伪装成临床意义不大的空气。如果不取出这些异物，可能会有感染风险。小儿神经外科医生在鉴别诊断钝器伤后可能导致颅骨骨折的异物时应考虑到发饰。
