Intraorbital Encephalocele: An Important Complication of Orbital Roof Fractures in Pediatric Patients
Intraorbital Encephalocele: An Important Complication of Orbital Roof Fractures in Pediatric Patients
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眶内脑膨出：儿科患者眼眶顶骨折的一个重要并发症
DOI：
10.1159/000072868
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发表时间：
2003
影响因子：
0.7
通讯作者：
Baran Sahinbeyoglu
中科院分区：
文献类型：
--
作者：
S. Cayli;A. Koçak;A. Alkan;R. Kutlu;A. Tekiner;O. Ates;Baran Sahinbeyoglu
眶顶骨折并不常见，外伤性眶内脑膨出形成是这种类型损伤的非常罕见的并发症。我们在4年的时间里治疗了43例眶顶骨折的儿童患者。本研究的目的是回顾性调查可能导致眶顶骨折儿童眶内脑膨出形成的情况。对每例患者进行回顾性分析，记录受伤原因、相关临床和计算机断层扫描结果、入院时格拉斯哥昏迷评分、神经系统状态、其他身体损伤、住院时间以及眶顶骨折的类型和宽度。将6例发生脑膨出的患者的结果与37例未发生该并发症的患者的相应结果进行比较。共44例眶顶骨折经轴位和冠状位计算机断层扫描诊断。43名儿童中有6名在头部外伤后的第一个月内发生眶内脑膨出。在这些病例中，磁共振成像显示眶内囊性病变与蛛网膜下腔相通。在轴向和冠状面计算机断层扫描切片上测量每个眶顶骨折的宽度，并在手术期间通过测量进行确认。脑膨出者骨折宽度2-4 mm，均行硬脑膜成形术和眶成形术。眶顶骨折的儿童患者表现出超过2 mm的肿胀，并与额叶脑挫伤相关，可能发生眶内脑膨出的风险更大。所有这些病例都应密切监测，并通过磁共振成像进行进一步调查。
Orbital roof fractures are uncommon, and traumatic intraorbital encephalocele formation is a very rare complication of this type of injury. We treated 43 pediatric patients with orbital roof fractures at our center over a 4-year period. The aim of this study was to retrospectively investigate conditions that may lead to intraorbital encephalocele formation in children with orbital roof fractures. Each case was reviewed, and the cause of injury, associated clinical and computerized tomography findings, the Glasgow Coma Scale score on admission, neurological status, other bodily injuries, hospitalization time and type and width of the orbital roof fracture were recorded. The findings in 6 patients who developed encephaloceles were compared to corresponding findings in the 37 patients who did not develop this complication. A total of 44 orbital roof fractures were diagnosed by axial and coronal computed tomography scanning. Six of the 43 children developed intraorbital encephaloceles in the first month after head trauma. In each of these cases, magnetic resonance imaging demonstrated the intraorbital cystic lesion in communication with the subarachnoid space. The width of each orbital roof fracture was measured on axial and coronal computed tomography slices and was confirmed by measurements during surgery. The width of the fractures in the encephalocele cases ranged from 2–4 mm. Duraplasty and orbitoplasty were performed in all the patients with encephalocele. Pediatric patients with orbital roof fractures that exhibit more than 2 mm diastasis and are associated with frontal cerebral contusion may be at greater risk for developing intraorbital encephalocele. All such cases should be monitored closely and investigated further with magnetic resonance imaging.