Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, Maryland, USA.
AJNR Am J Neuroradiol. 2011 Nov-Dec;32(10):1806-11. doi: 10.3174/ajnr.A2606. Epub 2011 Aug 18.
REHs and tectorial membrane injuries are rare complications of pediatric head and neck injuries. We aim to describe the neuroimaging findings in pediatric REHs, to summarize the mechanism of injury, and to correlate the imaging findings with the clinical presentation. We retrospectively evaluated CT and/or MR imaging studies of 10 children with traumatic REH. Most patients were involved in MVAs. The tectorial membrane was injured in 70% of patients, and REHs were medium to large in 80%. None of the patients had a focal spinal cord or brain stem injury, craniocervical junction dislocation, or vertebral fractures. Tectorial membrane disruption was diagnosed in most patients without craniocervical junction-related symptoms. Tectorial membrane lesions and REHs were seen in young children who sustained high-speed head and neck injuries. Clinical symptoms may be minimal or misleading. The radiologist should be aware of these injuries in children. MR imaging appears to be more sensitive than CT.
REH 和盖膜损伤是儿童头颈部损伤的罕见并发症。我们旨在描述儿童 REH 的神经影像学表现，总结损伤机制，并将影像学表现与临床表现相关联。我们回顾性评估了 10 例创伤性 REH 儿童的 CT 和/或 MRI 研究。大多数患者涉及多车事故。70%的患者盖膜受伤，80%的患者 REH 中等至大。没有患者出现局灶性脊髓或脑干损伤、颅颈交界脱位或椎体骨折。大多数没有颅颈交界相关症状的患者诊断为盖膜破裂。盖膜病变和 REH 见于遭受高速头颈部损伤的幼儿。临床症状可能很少或具有误导性。放射科医生应该意识到这些在儿童中的损伤。磁共振成像似乎比 CT 更敏感。
