吉林大学学报(医学版) ›› 2018, Vol. 44 ›› Issue (01): 175-178.doi: 10.13481/j.1671-587x.20180134

• 临床医学 • 上一篇    下一篇

先天乳突发育不良致颅内积气1例报告及文献复习

姜亚磊, 王育波, 曹赢坤, 耿任, 徐梦奇, 于明鑫, 李蕴潜   

  1. 吉林大学第一医院神经外科, 吉林 长春 130021
  • 收稿日期:2017-06-01 出版日期:2018-01-28 发布日期:2018-01-24
  • 通讯作者: 李蕴潜,主任医师,博士研究生导师(Tel:0431-88575701,E-mail:yunqian-li@foxmail.com) E-mail:yunqian-li@foxmail.com
  • 作者简介:姜亚磊(1991-),男,河南省漯河市人,在读医学硕士,主要从事神经系统肿瘤的基础和临床方面的研究。
  • 基金资助:
    吉林省科技厅科研基金资助课题(20160312017ZG)

Pneumocephalus caused by congenital mastoid dysplasia: A case report and literature review

JIANG Yalei, WANG Yubo, CAO Yingkun, GENG Ren, XU Mengqi, YU Mingxin, LI Yunqian   

  1. Department of Neurosurgery, First Hospital, Jilin University, Changchun 130021, China
  • Received:2017-06-01 Online:2018-01-28 Published:2018-01-24

摘要: 目的:探讨1例先天乳突发育不良致颅内积气患者的诊疗过程,阐明颅内积气的临床特点、诊断方法和治疗策略。方法:患者因突发右上肢活动不灵伴言语笨拙12h入院,入院后完善头部CT及MRI检查,诊断为颅内积气,择期行瘘口及硬脑膜破损修补术,术后给予营养神经和预防感染等对症治疗,并嘱咐患者避免用力咳嗽、擤鼻、大便和打喷嚏等增加颅内压力的行为。结果:考虑该患者由于乳突壁先天发育不良,局部骨质菲薄,游泳剧烈呛咳使颅内外压力平衡遭到破坏,从而形成颅内积气,择期行瘘口及硬脑膜破损修补术,出院时患者右上肢肌力及语言功能恢复正常,复查头部CT显示颅内积气完全消失。结论:颅内积气在临床上很常见,原因多样,应结合患者病史及影像学表现探究其原因,采取最合理的治疗措施,以此缓解患者颅内压增高的症状、促进神经功能的恢复。

关键词: 硬脑膜破损修补术, 颅内积气, 颅内压, 乳突发育不良

Abstract: Objective: To investigate the diagnosis and treatment of one patient with pneumocephalus caused by congenital mastoid dysplasia,and to clarify the clinical features,diagnostic methods and treatment strategies of intracranial accumulation of pneumocephalus. Methods: The patient with ineffective right upper limb activity accompanied stupid speech for 12 h was admitted to hospital. After admission, the head CT and MRI examination were performed again,and the patient was diagnosed as pneumocephalus.The paitent scheduled for stoma repair, neurotrophic treatment,infection prevention and other symptomatic treatments were performed after operation;the patient was instructed avoid cough forcefully,blowing nose,defecating and sneezing to increase the intracranial pressure. Results: Due to congenital dysplasia of mastoid wall, local thinning bones and intense swimming choking cough of the patient destroyed the intracranial pressure balance to form pneumocephalus,the patient scheduled for stoma and damaged dura repair;when discharged from hospital, the patient's right upper limb muscle strength and language function returned to normal;the head CT results showed that pneumocephalus disappeared completely. Conclusion: Pneumocephalus is common in clinic,and its reason is diversiform; it should be combined with the patient's history and imaging findings to explore the causes,the most reasonable treatment measures should be performed in order to relieve the patient's symptoms of increased intracranial pressure,and promote the recovery of neural function.

Key words: mastoid, intracranial pressure, dysplasia, pneumocephalus, dural damage repair

中图分类号: 

  • R651.11