Onur Ozge Ozberk, Demir Hasan, Guneysel Ozlem
Department of Emergency Medicine, Tophanelioglu C, Yurtacan S No 13-15, Altunizade, Istanbul, Turkey.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.10.2008.1028. Epub 2009 Mar 5.
A 66-year-old man was brought in to our emergency department (ED) with head trauma and was diagnosed with frontal located pneumocephalus based on a cranial computed tomography (CT) scan. At the time of arrival, he was alert and his Glasgow Coma Score (GCS) was 15. A neurological examination revealed no deficit and during follow-up in the ED his GCS did not deteriorate. Cranial CT scan demonstrated nasal fracture. On maxillofacial CT examination, we detected a nasal bone fracture, air loss and fluid was seen in the maxillary and ethmoid sinuses. In our case, pneumocephalus is assumed to be the result of ethmoid bone fracture. Despite the large amount of air in the subdural area, our patient had no symptoms. He was admitted to the intensive care unit for close monitoring and was discharged from hospital without neurological deficit on the fifth day of follow-up.
一名66岁男性因头部外伤被送至我院急诊科,经头颅计算机断层扫描(CT)诊断为额叶气颅。入院时,他意识清醒,格拉斯哥昏迷评分(GCS)为15分。神经系统检查未发现功能缺损,在急诊科随访期间其GCS未恶化。头颅CT扫描显示鼻骨骨折。在颌面CT检查中,我们发现鼻骨骨折,上颌窦和筛窦有气体流失及积液。在我们的病例中,气颅被认为是筛骨骨折的结果。尽管硬膜下区域有大量气体,但我们的患者没有症状。他被收入重症监护病房进行密切监测,随访第五天出院,无神经功能缺损。