Yamasaki Fumiyuki, Ohge Hiroki, Tsumura Ryu, Watanabe Yosuke, Nosaka Ryo, Akiyama Yuji, Ishifuro Minoru, Eguchi Kuniki, Tominaga Atsushi, Kurisu Kaoru
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University.
No Shinkei Geka. 2013 Nov;41(11):1001-9.
This 4-year-old girl fell while holding plastic chopsticks and a chopstick penetrated her left eye. The chopstick was removed immediately by herself. Conventional CT and MR images showed a penetration track from the orbital roof to the basal ganglia. On susceptibility-and diffusion-weighted images the track and surrounding cytotoxic edema were visualized more clearly. Although antibiotics were started at the time of admission to prevent intracranial infection, she developed meningitis. Subsequent treatment with carbapenem antibiotic-and vancomycin therapy was curative and she was discharged home 4 weeks after the injury. In our review of the literature on intracranial penetrating injuries via the orbita we compared the injury patterns inflicted by and the clinical observations reported on damage induced by wooden-, plastic-, and metal chopsticks. We also evaluated diagnostic CT and MR images in patients with intracranial penetrating injuries caused by chopsticks and documented the advantage of susceptibility-and diffusion-weighted imaging over conventional CT-and MR imaging.
这个4岁女孩拿着塑料筷子摔倒,一根筷子刺入她的左眼。筷子被她自己立即拔出。常规CT和MR图像显示从眶顶到基底节的穿透轨迹。在磁敏感加权成像和扩散加权图像上,轨迹及周围的细胞毒性水肿显示得更清楚。尽管入院时就开始使用抗生素以预防颅内感染,但她仍患上了脑膜炎。随后使用碳青霉烯类抗生素和万古霉素治疗取得了疗效,受伤4周后她出院回家。在我们对经眼眶颅内穿透伤的文献回顾中,我们比较了木质、塑料和金属筷子造成的损伤模式以及所报告的损伤临床观察结果。我们还评估了筷子所致颅内穿透伤患者的诊断性CT和MR图像,并记录了磁敏感加权成像和扩散加权成像相对于传统CT和MR成像的优势。