Day C J, Nolan J P, Tarver D
Department of Anaesthesia, Bristol Royal Infirmary.
Anaesthesia. 1994 Dec;49(12):1061-3. doi: 10.1111/j.1365-2044.1994.tb04357.x.
A 70-year-old man sustained a severe head injury following a fall downstairs, which resulted in him being found in a head down position. In the accident and emergency department he was noted to have subarachnoid air on a lateral cervical spine radiograph. This drew attention to the presence of fractures in the middle cranial fossa and nitrous oxide was immediately discontinued. The presence of a traumatic pneumomylogram implies a base of skull or middle cranial fossa fracture, and is almost certainly associated with intracranial subarachnoid air. Early recognition of the condition, and cessation of nitrous oxide, is essential to prevent dangerous increases in intracranial pressure secondary to the diffusion of gas into the air filled cavity.
一名70岁男性在从楼梯上摔下后头部受重伤，被发现时处于头朝下的姿势。在急诊室，他的颈椎侧位X线片显示有蛛网膜下腔积气。这引起了对中颅窝骨折的关注，一氧化二氮立即停用。创伤性气脑造影的存在意味着颅骨底部或中颅窝骨折，几乎肯定与颅内蛛网膜下腔积气有关。早期识别这种情况并停止使用一氧化二氮，对于防止气体扩散到充满空气的腔隙导致颅内压危险升高至关重要。
