小儿颅骨骨折远期并发症的临床和影像学研究

目的：通过对小儿颅骨骨折重要的远期并发症—生长性骨折的研究，为临床上避免颅脑损伤后出现远期并发症提供参考。方法：９例儿童生长性骨折患儿有明确头部外伤史。应用Ｘ线平片，头颅ＣＴ扫描，磁共振成像（ＭＲＩ）和其中３例颅骨修补术进行观察。同时应用经颅多普勒超声技术（ＴＣＤ）对９例患儿的颅内血流速度进行了检测。结果：头颅正侧位平片、ＣＴ和ＭＲＩ可见大小不等的颅骨缺损区，单侧或双侧脑萎缩，脑囊肿形成和脑穿通畸形出现。３例患者实施手术治疗，术中可见帽状腱膜下组织增厚、骨缺损边缘骨板全层增厚。ＴＣＤ可见５例患儿颅内血流速度减低为１０～３５ｃｍ／ｓ；２例患儿血流速度正常；２例血流速度略高。结论：儿童颅骨生长性骨折作为颅骨骨折重要的远期并发症其诊断意义非常重要。颅骨骨折和硬脑膜破裂是生长性骨折的决定性因素。ＴＣＤ对检测颅内血流动力学有重要的参考意义。

Clinical and Imaging Studies on the Remote Complication of Skull Fracture in Childhood

Objective: In order to avoid longterm concomitant symptom after head injury by clinical and imaging studies on the remote complication skull fracture in childhood.Methods: 9 cases suffering from growing skull fracture in childhood.Research was administered by X ray conputed tomography (CT).Magnetic resonance imaging (MRI) of head,transcranial Doppler(TCD) ultrasongraphy and head operation.Results:Skull defect,circumscribed atrophy of brain,syringog encephalia,cicatrix of menings and other findings were showed by imaging methods and operation.Velocities of middle cerebral artery were 10～35 cm/s in 5 patients.Normal blood velocity in 2 patients and faster blood velocity in 2 patients.Conclusion:The diagnosis of growing skull fracture in childhood is very important.The pathologic process of growing skull fractrue in childhood is complex in many ways.Transcranial Doppler ultrasonography is a very useful tool offering a help about cerebrovas cular hemodynamics.