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成人期出现的迟发性生长性颅骨骨折:一例报告。

Neglected growing skull fracture presenting in adulthood: A case report.

作者信息

Ghimire Sagun, Shrestha Shikher, Shrestha Dinuj, Awal Sudarshan, Subedi Ram Prasad, Ranabhat Kajan

机构信息

Department of Neurosurgery, B and B Hospital, Gwarko, Lalitpur, Nepal.

Department of Neurosurgery, B and B Hospital, Gwarko, Lalitpur, Nepal.

出版信息

Int J Surg Case Rep. 2025 Jan;126:110765. doi: 10.1016/j.ijscr.2024.110765. Epub 2024 Dec 23.

Abstract

INTRODUCTION AND IMPORTANCE

Growing skull fracture is one the rarest complication of skull fracture. They are identified mostly in infancy and children's, secondary to head trauma but there exist possibility of missed diagnosis in childhood and patient presenting in adulthood with delayed complications. Hence timely diagnosis and prompt management is mandatory.

CASE SUMMARY

A 26 years old female presented two decades later with bony scalp swelling associated with neurological complaints and cosmetic deformity. In depth history and workup diagnosed it a growing skull fracture. Patient underwent excision of the defect along with titanium mesh cranioplasty.

DISCUSSION

Among the cases of skull fracture, growing skull fracture is least encountered entity. Such fractures gets usually diagnosed very early after trauma, rarely it have been encountered decades later. More the delay more complications the patient usually presents with. Intraoperatively as well anatomy can be altered resulting difficulty in definitive management, however titanium mesh cranioplasty comes handy in bringing about good outcomes.

CONCLUSION

Childhood traumas are most neglected mostly in lower middle income countries hence the delay in intervention and future complications. If any forms of definitive injury could be diagnosed immediately after trauma such misfortunate presentation decades later can be prevented and quality of life the patient can be maintained.

摘要

引言与重要性

生长性颅骨骨折是颅骨骨折最罕见的并发症之一。它们大多在婴儿期和儿童期被发现,继发于头部外伤,但在儿童期存在漏诊的可能性,并且成年患者可能会出现延迟并发症。因此,及时诊断和迅速处理是必不可少的。

病例摘要

一名26岁女性在二十年后出现头皮骨质肿胀,并伴有神经症状和外观畸形。通过详细的病史询问和检查,诊断为生长性颅骨骨折。患者接受了缺损切除及钛网颅骨成形术。

讨论

在颅骨骨折病例中,生长性颅骨骨折是最少见的情况。此类骨折通常在创伤后很早就被诊断出来,很少在数十年后才被发现。延迟的时间越长,患者通常出现的并发症就越多。术中解剖结构也可能发生改变,导致确定性治疗困难,然而钛网颅骨成形术有助于取得良好的治疗效果。

结论

在中低收入国家,儿童期创伤大多被忽视,因此导致干预延迟和未来并发症。如果在创伤后能立即诊断出任何形式的确定性损伤,就可以预防数十年后这种不幸的情况发生,并维持患者的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d745/11741045/fe1392a3fcff/gr1.jpg

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