Wang J, Bartkowski H M
Division of Neurosurgery, Ohio State University Columbus Children's Hospital, Columbus, USA.
Neuropediatrics. 1997 Jun;28(3):184-8. doi: 10.1055/s-2007-973698.
Leptomeningeal cyst as a rare complication of skull fracture in children is well documented. Most cases occur months or years after the original skull fracture, with characteristic roentgenogram findings. The authors report two cases of leptomeningeal cysts in children less than two years old. The association of hygroma, severe brain injury, increased ICP, and early development of leptomeningeal cyst are discussed. Both patients sustained parietal diastatic skull fracture and developed external brain herniation within 10 days after motor vehicle accidents. Clinically they presented with seizure, hemiparesis, and an enlarging subgaleal mass over the skull fracture. MRI demonstrated severe underlying brain contusion, hygroma around the fracture site, and brain herniation through the skull fracture. Surgical repair of dural laceration and cranioplasty produced good results. The development of hygroma and increased intracranial pressure might account for the early development of leptomeningeal cysts in these two cases.
作为儿童颅骨骨折罕见并发症的软脑膜囊肿已有充分记载。大多数病例发生在原发颅骨骨折数月或数年之后，具有特征性的X线表现。作者报告了两例两岁以下儿童的软脑膜囊肿病例。文中讨论了脑脊膜膨出、严重脑损伤、颅内压升高与软脑膜囊肿早期形成之间的关联。两名患者均在机动车事故后10天内发生顶骨分离性颅骨骨折并出现脑外疝。临床上，他们表现为癫痫发作、偏瘫以及颅骨骨折处帽状腱膜下肿块增大。磁共振成像显示严重的潜在脑挫伤、骨折部位周围的脑脊膜膨出以及脑通过颅骨骨折处疝出。硬脑膜撕裂修补术和颅骨成形术取得了良好效果。脑脊膜膨出的形成和颅内压升高可能是这两例软脑膜囊肿早期形成的原因。
