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11.
Posterior cranial fossa dimensions in the Chiari I malformation: Relation to pathogenesis and clinical presentation 总被引:8,自引:0,他引:8
Summary Skull dimensions were measured on lateral skull radiographs in 33 adult patients with MRI-verified Chiari I malformations and in 40 controls. The posterior cranial fossa was significantly smaller and shallower in patients than in controls. In the patients, there was a positive correlation between posterior fossa size and the degree of the cerebellar ectopia, which might indicate that a posterior cranial fossa which was originally too small had been expanded by the herniation of hindbrain structures at an early stage. Pyramidal signs and cerebellar symptoms and signs, which may be due to compression of neural structures, were associated with a large degree of ectopia and a relatively large posterior cranial fossa. Syringomyelia and headache, which may be due to the valve action of the herniated cerebellar tissue, were not associated with a particularly large posterior fossa or herniation. No special clinical presentation was associated with a very small posterior cranial fossa, which may indicate that a small posterior cranial fossa per se has little or no clinical significance, although it may be the primary developmental anomaly. 相似文献
12.
Patrick M. Rao M.D. A. John Kuta M.D. Michele H. Johnson M.D. 《Emergency radiology》1995,2(5):303-304
We present a case in which an open fracture of the ulna penetrated the skull and caused a comminuted, depressed skull fracture
with a large intraparenchymal hematoma containing bone fragments. 相似文献
13.
胚胎颅骨骨膜移植修复髋关节软骨大面积缺损 总被引:9,自引:3,他引:6
1990年5月~1994年4月,对42例(47个髋)关节软骨全厚缺损患者采用冷冻保存胚胎颅骨骨膜移植进行修复,其中14例股骨头骨质Ⅳ期坏死者,同时施行带旋髂深血管蒂髂骨植骨。对34例(38个髋)进行了2年~6年(平均40个月)随访。结果表明,按照吴之康髋关节人工置换术后疗效评定标准,优良25例,很好5例,好3例,尚可1例。认为,与自体移植物修复关节软骨大面积缺损相比,这种方法无附加损伤,具有移植材料、形态与股骨头相似等特点,是治疗髋关节软骨大面积缺损的一种有效方法。 相似文献
14.
目的:探讨及早应用胰岛素对颅脑外伤后高血糖患者治疗转归的影响。方法:对83例颅脑外伤后血糖升高者于入院时及伤后第1、2、3、5、7、10、14(如血糖仍未恢复正常者酌情延长时间)日晨空腹抽血检测血糖。且在使用胰岛素期间对末梢血糖进行动态的监测直至清晨空腹静脉血糖连续2次正常,同时制定饮食护理措施及对患者或家属进行相应的健康教育。结果:血糖升高者中72.12%(59例)的患者血糖在1-3d内恢复正常,且预后与血糖正常者无差别。组中仅7例患者血糖持续升高,均因伤情重而死亡,占本组重症(GCS≤8分)患者(25例)的29.41%,明显低于文献报道组。结论:对颅脑外伤后高糖血患者尽早应用胰岛素,能改善患者预后,降低死亡率。 相似文献
15.
Abstract – A histometric method was applied for evaluation of root resorption in 57 experimentally replanted teeth and 22 controls. Representative axiobuccolingual sections were selected for measurement of resorptions at a magnification of × 40. The frequency of root resorption in the control teeth was low. In replanted teeth marked resorptive activity elicited by the trauma appeared after 2 wk. The extent of active resorptions increased until the third postoperative week. On an average 14% of the root periphery was affected at this stage. After the sixth postoperative week progressive cement deposition took place in the resorption lacunae. Incidental ankylosis of the periodontal membrane also occurred from this observation time but there was no increase among the long-term groups. 相似文献
16.
Aims and Objectives The significance of beaten copper appearance (BCA) on skull radiographs in children following surgery for isolated sagittal
craniosynostosis has not been studied. This study was designed to look for any correlation between BCA and symptoms suggestive
of intracranial hypertension in this group of patients.
Materials and Methods Forty-eight consecutive children, who were operated for isolated sagittal synostosis from1987 to 2000 and had postoperative
skull radiographs, were included. Patients were divided into: (a) BCA group (n = 20), consisting of children who had beaten copper appearance on skull radiographs at last follow up, and (b) Non-BCA group
(n = 28), consisting of children who did not have this finding. Records were reviewed to look for symptoms suggestive of intracranial
hypertension, such as headache, head banging, and irritability.
Results Median age at surgery was 4.8 months for BCA group and 4 months for the non-BCA group. Follow up ranged from 4 to 156 months
with a mean of 36.2 months. Total of 28.6% (n = 6) of the children with follow up radiographs done at ≤18 months of age had BCA. The incidence of BCA increased to 83.3%
in children with skull radiographs performed after 48 months of age. In 18 (90%) children, the BCA was ‘diffuse’ with 5 (25%)
children having the maximum possible score of 8. In the BCA group, 45% (n = 9) had symptoms compared to 10.7% (n = 3) in the control group (p = 0.0068).
Conclusions This study suggests a significant number of children with BCA on radiographs develop symptoms suggestive of raised ICP following
surgical treatment in infancy and prolonged follow up may be warranted in this group of patients. 相似文献
17.
脑膜瘤骨侵袭行为中血管内皮生长因子表达研究 总被引:7,自引:1,他引:6
目的研究脑膜瘤不同的骨侵袭行为中血管内皮生长因子(VEGF)表达的差异性,探讨VEGF在骨侵袭中的生物学意义。方法应用HE染色和免疫组化方法检测36例脑膜瘤标本及受累骨质的病理类型及VEGF蛋白表达水平,进行病理学对比观察。结果36例标本中有骨侵袭的23例,VEGF表达为强阳性者5例,阳性者17例,阴性者1例;13例无肿瘤骨侵袭标本中,VEGF表达为强阳性者1例,阳性者6例,阴性者6例。脑膜瘤骨侵袭与VEGF表达程度显著相关(P<0.05)。VEGF主要表达于脑膜瘤细胞的胞浆,在肿瘤向骨组织浸润最明显处表达最强。结论VEGF表达水平反映脑膜瘤对相邻骨质的侵袭能力;VEGF参与脑膜瘤骨病理改变的形成机制。 相似文献
18.
19.
瘤体骨切除灭活再植治疗四肢长骨巨细胞瘤 总被引:21,自引:0,他引:21
体内刮除及灭活植骨治疗骨巨细胞瘤(GCT)的复发率高。我科从1986年6月~1996年2月治疗四肢长骨GCT24例。随访11个月~8年4个月。其中7例采用局部切刮体内灭活植骨和(或)骨水泥充填治疗。结果1例感染,6例复发,1例恶变后死于肺转移。作者自1991年1月采用瘤体骨切除,离体灭活再植,与骨残端体内灭活相结合,骨缺损采用自家腓、髂骨移植,L-梯形加压钢板(L-TCP)或梯形加压钢板(TCP)固定治疗17例,其中12例保留关节,5例做膝关节融合。本组无菌创口感染1例,1例复发。在保留关节的12例中9例关节功能恢复优良,1例尚可,2例差。充分说明瘤段骨切除体外灭活再植术疗效确实,复发率低。保留关节术式适于关节破坏较轻(<=1/2)者,结合关节残端体内灭活和有效的骨结构重建,有利于恢复关节功能。如关节面累及>1/2,宜做骨关节端切除,灭活再植,下肢宜做关节融合或人工关节置换术。 相似文献
20.