Makino Kensaku, Tsutsumi Satoshi, Takaki Yuki, Nonaka Senshu, Okura Hidehiro, Ishii Hisato
Department of Neurological Surgery, Juntendo University Urayasu Hospital.
Radiol Case Rep. 2021 Aug 5;16(10):2981-2983. doi: 10.1016/j.radcr.2021.07.023. eCollection 2021 Oct.
A 6-month-old, previously healthy boy hit the right frontal region of his head against the corner of a plastic toy box. At presentation, a small area with scalp discoloration was noted in the right frontal region. Head computed tomography at the level of discoloration revealed an intracranial hematoma, 5 mm in maximal thickness, below the coronal suture. In addition, there were bony bridges connecting the frontal and parietal bones. Furthermore, a linear crack was found in the diploe of the frontal bone in contact with the coronal suture. Cerebral MRI confirmed linear hyperintensity between the inner tables. We assumed that a kind of ping-pong ball fracture was caused by the head blow, centering on the coronal suture, resulting in rupture of contacting diploic channels and tear of the dura mater, and forming a subdural hematoma. Acute subdural hemorrhage may be caused by an insignificant blow to the coronal suture in infantile patients with underdeveloped cranial bones and sutures, accompanied by subtle external findings.
一名6个月大、此前健康的男童头部右侧额部撞到了塑料玩具箱的角上。就诊时,右侧额部可见一小片头皮变色区域。在变色区域层面进行的头部计算机断层扫描显示,冠状缝下方有一颅内血肿,最大厚度为5毫米。此外,有骨桥连接额骨和顶骨。而且,在与冠状缝接触的额骨板障内发现一条线性裂缝。脑部磁共振成像证实内板之间存在线性高信号。我们推测,此次头部撞击以冠状缝为中心导致了一种乒乓球样骨折,致使接触的板障通道破裂和硬脑膜撕裂,进而形成硬膜下血肿。在颅骨和缝合线发育不全的婴幼儿患者中,冠状缝受到轻微撞击可能会导致急性硬膜下出血,且伴有细微的外部表现。