1/5. Traumatic basilar artery occlusion caused by a fracture of the clivus--case report.A 56-year-old man presented with a rare traumatic basilar artery occlusion caused by a fracture of the clivus. He fell from the height of 2 meters and immediately fell into a coma. head computed tomography (CT) revealed an open depressed fracture, an acute epidural hematoma 1 cm thick in the left middle frontal fossa, and a longitudinal fracture of the clivus. Emergency removal of the hematoma was performed with cranioplasty. head CT 8 hours 50 minutes after injury showed infarctions in the brain stem, cerebellum, and occipital lobes. cerebral angiography revealed occlusion of the basilar artery in the middle part of the clivus. The patient died after 3 days. autopsy revealed that the basilar artery was trapped in the clivus fracture site. Vertebrobasilar artery occlusion due to trapping in a clivus fracture has a very poor prognosis. diagnosis is difficult and generally only confirmed at autopsy. cerebral angiography is recommended in a patient in a deep coma without massive brain contusion at the early stage of head injury to identify the possibility of vertebrobasilar artery occlusion in a clivus fracture.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
2/5. Cranioplasty for patients with severe depressed skull bone defect after cerebrospinal fluid shunting.Cranioplasty is indicated for patients with a skull bone defect. patients may achieve subjective and objective improvements after cranioplasty. Some patients with severe brain swelling treated with decompressive craniectomy may develop hydrocephalus associated with severe brain bulging or even herniation via the skull bone defect. Consequently, these patients require a ventriculoperitoneal (V-P) shunt to relieve hydrocephalus. However, after shunting for hydrocephalus, they may develop severe sinking at the skull defect. Subsequently, when doing a cranioplasty for such a depressed defect, it may result in the dysfunction of the underlying brain, or even hematoma formation due to the large dead space. In this study, we advocate a temporary procedure to occlude the V-P shunt tube to allow the expansion of a depressed scalp flap to facilitate the subsequent cranioplasty. We report four patients with severe depression of the skull defect resulting from previous traumatic brain swelling followed by decompressive craniectomy and V-P shunting for communicating hydrocephalus. A simple subcutaneous clipping of the shunt tube was performed to allow the expansion of the depressed scalp to obliterate the dead space before the cranioplasty. All four patients obtained a satisfactory result without complications and achieved good functional recovery. A temporary occlusion of the shunt tube with an aneurysm clip before cranioplasty for patients with a severely depressed scalp flap is a simple and useful procedure. This procedure can safely and effectively eliminate the dead space between the skull plate and the dura to facilitate the cranioplasty, and thus prevent the potential complication of intracranial hematoma.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
3/5. Depressed skull fracture and epidural haematoma: an unusual post-operative complication of pin headrest in an adult.Depressed skull fracture and epidural haematoma caused by pin headrest complicated the post-operative course in an adult, after removal of a parasagittal meningioma. The calvarial thickness was observed to be significantly reduced due to chronic high intracranial pressure. Potentially hazardous complications of pin headrests should not be underestimated in adults.- - - - - - - - - - ranking = 5keywords = dura (Clic here for more details about this article) |
4/5. Camel bite: an unusual type of head injury in an infant.Small children are predisposed for animal bite wounds in the craniofacial region, because the likelihood of sustaining trunk and extremity injuries increases with height. The clinical picture of animal bite wounds is highly variable. Depending on the dental anatomy of the biting animal, such wounds may range from sharp stitch wounds to extensive lacerations with or without tissue loss. The ears and nose are injured most often because of their exposed location. Nevertheless, depressed skull fractures with injury to the dura and to the brain parenchyma are extremely rare. This case presentation describes the rare case of a craniocerebral camel bite wound (Lackmann stage IV B) in a 3-year-old girl that required immediate neurosurgical management. The neurosurgical management, choice of antibiotic, postoperative treatment, and clinical course are discussed, and background information on camel bite injuries is given.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
5/5. Delayed occurrence of intracranial supratentorial chondroma following compound depressed skull fracture.We describe an exceptional case of a frontal convexity chondroma arising at the site of a compound depressed skull fracture operated on 12 years earlier. We conclude that intracranial chondroma should be included in the differential diagnosis of a calcified mass for the patients who had had a compound, depressed skull fracture along the suture line, especially in cases of dural laceration by the fragmented bone.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |