非典型斜坡骨折导致脑脊液鼻漏及继发细菌性脑膜炎
Cerebrospinal Fluid Rhinorrhea and Subsequent Bacterial Meningitis due to an Atypical Clival Fracture.
作者信息
Tohge Rie, Takahashi Makio
机构信息
Department of Neurology, Osaka Red Cross Hospital, Japan.
出版信息
Intern Med. 2017;56(14):1911-1914. doi: 10.2169/internalmedicine.56.8186. Epub 2017 Jul 15.
Abstract
Cases of cerebrospinal fluid (CSF) rhinorrhea due to clival fracture are rare. We present a case of bacterial meningitis with CSF rhinorrhea after a clival fracture. Heavily T2-weighted images showed a bone flap in the thinned clivus and fluid collection in the sphenoid sinus. CSF rhinorrhea developed at 1 month after mild trauma. The fracture may have been caused by the trauma and/or by the pressure gradient between the intracranial CSF space and the sphenoid sinus. A detailed history to identify trauma and an examination to detect bone defects in the skull base are necessary when patients present with bacterial meningitis and persistent rhinorrhea.
摘要
因斜坡骨折导致脑脊液鼻漏的病例较为罕见。我们报告一例斜坡骨折后出现细菌性脑膜炎并伴有脑脊液鼻漏的病例。重度T2加权图像显示变薄的斜坡处有骨瓣形成，蝶窦内有液体积聚。轻度外伤后1个月出现脑脊液鼻漏。骨折可能是由外伤和/或颅内脑脊液间隙与蝶窦之间的压力梯度所致。当患者出现细菌性脑膜炎和持续性鼻漏时，详细询问外伤史并检查以发现颅底骨缺损是必要的。
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本文引用的文献
1
Non-Invasive and Minimally Invasive Imaging Evaluation of CSF Rhinorrhoea - a Retrospective Study with Review of Literature.
Pol J Radiol. 2016 Feb 29;81:80-5. doi: 10.12659/PJR.895698. eCollection 2016.
2
Endoscopic Endonasal Repair of Cerebrospinal Fluid Leakage Caused by a Rare Traumatic Clival Fracture.
Neurol Med Chir (Tokyo). 2016;56(2):81-4. doi: 10.2176/nmc.cr.2015-0152. Epub 2016 Jan 22.
3
Clival fractures in a level I trauma center.
J Neurosurg. 2015 Jan;122(1):227-35. doi: 10.3171/2014.9.JNS14245.
4
Primary spontaneous cerebrospinal fluid leaks located at the clivus.
Allergy Rhinol (Providence). 2013 Summer;4(2):e100-4. doi: 10.2500/ar.2013.4.0053.
5
Ecchordosis physaliphora and its variants: proposed new classification based on high-resolution fast MR imaging employing steady-state acquisition.
Eur Radiol. 2013 Oct;23(10):2854-60. doi: 10.1007/s00330-013-2888-9. Epub 2013 Aug 1.
6
Purely endoscopic repair of traumatic cerebrospinal fluid rhinorrhea from the anterior skull base: case report.
Neurol Med Chir (Tokyo). 2011;51(3):222-5. doi: 10.2176/nmc.51.222.
7
Heavily T2-weighted MR myelography vs CT myelography in spontaneous intracranial hypotension.
Neurology. 2009 Dec 1;73(22):1892-8. doi: 10.1212/WNL.0b013e3181c3fd99.
8
Fractures of the clivus: a contemporary series in the computed tomography era.
Neurosurgery. 2009 Dec;65(6):1063-9; discussion 1069. doi: 10.1227/01.NEU.0000360154.18604.28.
9
Risk of meningitis with cerebrospinal fluid rhinorrhea.
Ann Otol Rhinol Laryngol. 2007 Dec;116(12):902-5. doi: 10.1177/000348940711601206.
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