Tsukada Atsushi, Yanaka Kiyoyuki, Takeda Hayato, Onuma Kuniyuki, Takada Maya, Nakamura Kazuhiro, Ishikawa Eiichi
Department of Neurosurgery, University of Tsukuba, Tsukuba, Japan.
Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Japan.
Surg Neurol Int. 2022 Nov 4;13:503. doi: 10.25259/SNI_789_2022. eCollection 2022.
Calvarial bone thinning is a rare clinical entity, with only several cases reported (including Gorham-Stout disease), but the cause is often unknown. Here, we report such a case of unilateral calvarial thinning with an unknown cause.
A 77-year-old woman undergoing imaging examination for unruptured cerebral aneurysms for the past several years noticed a progressive cranial deformity. Computed tomography revealed progressive thinning of the right parietal bone and cranial deformity but laboratory tests showed no causative findings. A cranioplasty was performed to protect the brain and confirm the pathology. Grossly, pigmentation and deformity were observed on the outer plate of the bone but the inner plate was intact. Pathological examination revealed preserved bone cells and no necrosis. In addition, there were no findings of vascular hyperplasia or malignancy. It appeared that localized osteoporosis had occurred, mainly in the outer plate of the bone, but the cause was unclear.
Progressive focal calvarial thinning is rarely reported and the mechanism in this case was unknown. It is important to determine the cause of the bone thinning to evaluate the need for surgical intervention from the viewpoint of brain protection and prevention of cerebrospinal fluid leakage.
颅骨变薄是一种罕见的临床病症，仅有几例报道（包括戈勒姆 - 斯托特病），但其病因通常不明。在此，我们报告一例病因不明的单侧颅骨变薄病例。
一名77岁女性，在过去几年因未破裂脑动脉瘤接受影像学检查时，发现颅骨逐渐变形。计算机断层扫描显示右侧顶骨逐渐变薄及颅骨变形，但实验室检查未发现病因相关结果。为保护大脑并明确病理情况，进行了颅骨成形术。大体观察，骨外板有色素沉着和变形，但内板完整。病理检查显示骨细胞保存完好，无坏死。此外，未发现血管增生或恶性病变迹象。似乎发生了局限性骨质疏松，主要累及骨外板，但其病因不明。
进行性局灶性颅骨变薄鲜有报道，该病例的机制不明。从脑保护和预防脑脊液漏的角度确定骨变薄的病因对于评估手术干预的必要性很重要。
