Lee Jae Il, Ko Jun Kyeung, Cha Seung Heon, Han In Ho
Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
J Korean Neurosurg Soc. 2011 Dec;50(6):532-4. doi: 10.3340/jkns.2011.50.6.532. Epub 2011 Dec 31.
Temple trauma that appears initially localized to the skin might possess intracranial complications. Early diagnosis and management of such complications are important, to avoid neurologic sequelae. Non-penetrating head injuries with intracranial hemorrhage caused by a driven bone fragment are extremely rare. A 53-year-old male was referred to our hospital because of intracerebral hemorrhage. He was a mechanic and one day before admission to a local clinic, tip of metallic rod hit his right temple while cutting the rod. Initial brain computed tomography (CT) and magnetic resonance imaging demonstrated scanty subdural hematoma at right temporal lobe and left falx and intracerebral hematoma at both frontal lobes. Facial CT with 3-D reconstruction images showed a small bony defect at the right sphenoid bone's greater wing and a small bone fragment at the left frontal lobe, crossing the falx. We present the unusual case of a temple trauma patient in whom a sphenoid bone fragment migrated from its origin upward, to the contralateral frontal lobe, producing hematoma along its trajectory.
最初看似局限于皮肤的颞部创伤可能伴有颅内并发症。尽早诊断和处理此类并发症对于避免神经后遗症很重要。由驱动的骨碎片导致颅内出血的非穿透性头部损伤极为罕见。一名53岁男性因脑出血被转诊至我院。他是一名机械师，在当地诊所就诊前一天，切割金属棒时金属棒尖端击中了他的右颞部。最初的脑部计算机断层扫描（CT）和磁共振成像显示右颞叶和左大脑镰处有少量硬膜下血肿，双侧额叶有脑内血肿。面部CT三维重建图像显示右蝶骨大翼有一个小骨缺损，左额叶有一个小骨碎片，穿过大脑镰。我们报告了一例不寻常的颞部创伤患者，蝶骨碎片从其起源处向上迁移至对侧额叶，并沿其轨迹形成血肿。
