Uzan M, Ciplak N, Dashti S G, Bozkus H, Erdinçler P, Akman C
Department of Neurosurgery, Istanbul University, Cerrahpasa Medical Faculty, Turkey.
J Neurosurg. 1998 Mar;88(3):598-600. doi: 10.3171/jns.1998.88.3.0598.
The use of surgical treatment for depressed skull fractures that are located over major venous sinuses is a matter of controversy. However, if clinical and radiological findings of sinus obliteration and related intracranial hypertension are present, surgical decompression is indicated. The authors present the case of a 38-year-old man who had a depressed skull fracture overlying the posterior one-third portion of the superior sagittal sinus. The lesion was initially treated conservatively and the patient was readmitted 1 month later with signs and symptoms of intracranial hypertension. The role of radiological investigation in the detection of venous sinus flow and indications for surgical treatment are discussed. If venous sinus flow obstruction is revealed in the presence of signs and symptoms of intracranial hypertension, surgery is indicated as the first line of treatment.
对于位于主要静脉窦上方的凹陷性颅骨骨折，采用手术治疗存在争议。然而，如果出现静脉窦闭塞及相关颅内高压的临床和影像学表现，则需进行手术减压。作者报告了一例38岁男性病例，其颅骨骨折位于上矢状窦后三分之一段上方。该病变最初采用保守治疗，1个月后患者因颅内高压的体征和症状再次入院。本文讨论了影像学检查在检测静脉窦血流中的作用以及手术治疗的指征。如果在存在颅内高压体征和症状的情况下发现静脉窦血流受阻，则应将手术作为一线治疗方法。
