Kuwata T, Kamei I, Uematsu Y, Iwamoto M, Kuriyama T
Department of Neurosurgery, Wakayama Red Cross Hospital, Japan.
No Shinkei Geka. 1988;16(5 Suppl):677-81.
A case of growing skull fracture with rapid growth is presented. A 4-month-old male fell and struck the right side of his head. Skull X-ray just after injury showed a right parietotemporal linear skull fracture with the maximum width of 4 mm. The width of the fracture line increased to 9 mm 7 hours after injury. Serial CT scan demonstrated growth of contusional hematoma just beneath of the fracture. Six days later, a pulsatile mass was palpated beneath the scalp, although neurological state was normal. The width of the fracture line was demonstrated to increase up to 11 mm on X-ray at that time. CT scan revealed subgaleal cerebral herniation surrounded by brain edema. He was operated 11 days after injury. It is thought that the contusional hematoma and following brain edema played an important role in the genesis of rapid growth of the skull fracture.
本文报告一例生长迅速的颅骨骨折病例。一名4个月大的男性摔倒后撞到头部右侧。受伤后即刻的颅骨X线片显示右侧顶颞部线性颅骨骨折,最大宽度为4mm。受伤7小时后骨折线宽度增至9mm。系列CT扫描显示骨折下方挫伤性血肿增大。6天后,尽管神经状态正常,但在头皮下可触及搏动性肿块。此时X线片显示骨折线宽度增至11mm。CT扫描显示帽状腱膜下脑疝并伴有脑水肿。患者在受伤11天后接受手术。据认为,挫伤性血肿及随后的脑水肿在颅骨骨折快速生长的发生过程中起了重要作用。