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[三例颅内木质异物]

[Three cases of an intracranial wooden foreign body].

作者信息

Fujimoto S, Onuma T, Amagasa M, Okudaira Y

机构信息

Division of Neurosurgery, Sendai City Hospital, Japan.

出版信息

No Shinkei Geka. 1987 Jul;15(7):751-6.

PMID:3670545
Abstract

Three cases of intracranial wooden foreign body are reported discussing the diagnostic and therapeutic problems. First case is a 50-year-old man. After drinking, he drove a bike and fell to the ground. On admission the wooden foreign body could not been detected in appearance. CT scan showed low density area similar to air in bilateral anterior horn of lateral ventricle. The patient was treated for traumatic pneumocephalus at first. Later, it proved that he was stabbed with a foreign body penetrating into the contralateral frontal lobe through the left nasal cavity. It was extracted by endonasal approach by otolaryngologist, fortunately without trouble. The foreign body was a branch of tree. The second case is an 18-year-old man. He was driving a car, and suffered injury. He was stabbed with a wooden stake penetrating into his left eye. Immediately, bifrontal craniotomy was performed and the stake was withdrawn carefully. Moreover bone fragments were removed. The third case is a 61-year-old man. When he cut the timber by chain saw, a piece of wood hit and stabbed his right eye directly. Immediately right front temporal craniotomy was performed. The piece of wood was withdrawn from the right eye, and pieces of glass, wood and bone fragments were evacuated. It is difficult to confirm intracranial foreign body accurately by means of only plain skull film and usual CT scans. It is necessary to utilize various function of CT scanner. For example, it is useful to know CT values or select measure mode with window width and level or make reconstruction image to sagittal or coronal section, and so on.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本文报告了3例颅内木质异物病例,并讨论了诊断和治疗问题。第一例是一名50岁男性。饮酒后骑自行车摔倒在地。入院时外观未发现木质异物。CT扫描显示双侧侧脑室前角有类似空气的低密度区。患者最初按创伤性气颅进行治疗。后来证实他被异物经左鼻腔刺入对侧额叶。由耳鼻喉科医生经鼻内入路取出异物,所幸未出现问题。异物是树枝。第二例是一名18岁男性。他驾驶汽车时受伤。被木桩刺入左眼。立即进行双额开颅手术,小心取出木桩,还取出了骨碎片。第三例是一名61岁男性。他用链锯锯木材时,一块木头直接击中并刺入他的右眼。立即进行右额颞开颅手术。从右眼取出木头,并清除玻璃、木头和骨碎片。仅通过普通颅骨平片和常规CT扫描很难准确确认颅内异物。有必要利用CT扫描仪的各种功能。例如,了解CT值、选择窗宽和窗位的测量模式或制作矢状面或冠状面的重建图像等很有用。(摘要截取自250字)

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