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Neurology:钢筋贯穿颅脑后奇迹生还!惊叹外科手术的魅力

2015-06-03 MedSci MedSci原创

螺纹钢筋致穿透性颅脑损伤Peng Luo, MD and Zhou Fei, PhD, MD西京医院,第四军医大学。穿透性颅脑损伤导致伤情复杂和高死亡率。一名47岁的男子在施工过程中从4米高的脚手架跌倒,由螺纹钢筋造成在头部(图中,A和B)造成穿透性颅脑损伤。唯一的局灶性功能缺损为左瞳孔固定和扩张。CT成像显示,左视神经管(图中C)与左无颈内动脉(图中D)及海绵窦(图,E)的牵连被隔断。经过神经外

螺纹钢筋致穿透性颅脑损伤
Peng Luo, MD and Zhou Fei, PhD, MD
西京医院,第四军医大学。

穿透性颅脑损伤导致伤情复杂和高死亡率。

点击看早前的新闻报道:一例罕见颅脑贯通伤者成功获救

一名47岁的男子在施工过程中从4米高的脚手架跌倒,由螺纹钢筋造成在头部(图中,A和B)造成穿透性颅脑损伤。唯一的局灶性功能缺损为左瞳孔固定和扩张。CT成像显示,左视神经管(图中C)与左无颈内动脉(图中D)及海绵窦(图,E)的牵连被隔断。经过神经外科、颌面联合手术,患者恢复且无颅内感染、脓肿,无脑脊液漏,无癫痫。经过一个月的观察,患者除左眼失明,无神经系统后遗症。


穿透性颅脑损伤图像

螺纹钢筋(长度1米,直径2.5厘米)插入病人头部(A,B)。 CT扫描显示,钢筋的位置,左视神经管(C,绿色箭头),左侧颈内动脉(D,白色箭头),以及海绵窦(E,红色箭头)。

原始出处:

Peng Luo, MD and Zhou Fei, PhD, MD.Twisted steel–induced penetrating head injury.Neurology May 5, 2015 vol. 84 no. 18 1909

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    2016-11-24 wuhai

    ?

    0

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    2015-10-30 张志友

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=157914, encodeId=832115e9147d, content=?, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d2781928203, createdName=wuhai, createdTime=Thu Nov 24 18:24:12 CST 2016, time=2016-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=41915, encodeId=c34e41915f2, content=牛, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151030/IMG563256B548B0B5038.jpg, createdBy=359c1659769, createdName=张志友, createdTime=Fri Oct 30 01:44:00 CST 2015, time=2015-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999528, encodeId=7a02199952855, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Oct 26 13:03:00 CST 2015, time=2015-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=36109, encodeId=6b7a3610971, content=真厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=197, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f0651619268, createdName=84119448, createdTime=Thu Aug 27 13:21:00 CST 2015, time=2015-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=32300, encodeId=ecf3323007c, content=幸运, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d82d1631885, createdName=豪斯009, createdTime=Fri Jul 10 22:59:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=26884, encodeId=266826884bf, content=生命力顽强, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://api.medsci.cn/resource/upload/20150526/IMG5564536F3C41D5237.jpg, createdBy=4c0c1612254, createdName=summer474cn, createdTime=Wed Jun 10 14:28:00 CST 2015, time=2015-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1343276, encodeId=13d113432e6cb, content=<a href='/topic/show?id=d3ea4293676' target=_blank style='color:#2F92EE;'>#外科手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42936, encryptionId=d3ea4293676, topicName=外科手术)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Fri Jun 05 05:03:00 CST 2015, time=2015-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=25875, encodeId=72b9258e5b0, content=厉害一, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0d231626576, createdName=jjzouyan, createdTime=Wed Jun 03 22:00:00 CST 2015, time=2015-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=25849, encodeId=5e6f2584990, content=没有伤到重要脑组织,不过通过外科手术,能这样,厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e511627114, createdName=1dd7eb8am26(暂无匿称), createdTime=Wed Jun 03 16:06:00 CST 2015, time=2015-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=25840, encodeId=29472584050, content=该说是幸运还是不幸…, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150803/IMG55BF0A489B9F95355.jpg, createdBy=ac9e1624737, createdName=warmniu, createdTime=Wed Jun 03 15:03:00 CST 2015, time=2015-06-03, status=1, ipAttribution=)]
    2015-10-26 yinhl1978
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    2015-08-27 84119448

    真厉害

    0

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    2015-07-10 豪斯009

    幸运

    0

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    2015-06-10 summer474cn

    生命力顽强

    0

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    2015-06-03 jjzouyan

    厉害一

    0

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    2015-06-03 1dd7eb8am26(暂无匿称)

    没有伤到重要脑组织,不过通过外科手术,能这样,厉害

    0

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    2015-06-03 warmniu

    该说是幸运还是不幸…

    0

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6月20日,由山西医科大学第一医院神经外科主任郝解贺教授主持的“扩大经蝶入路切除侵袭海绵窦垂体腺瘤的临床研究”项目,日前在太原通过专家鉴定。专家组认为,该项研究成果达到了国际先进水平。 据悉,该项目以23例向海绵窦侵袭的垂体腺癌患者为研究对象,采用扩大经蝶入路,辅助神经内镜技术进行手术治疗,随后对这些患者的临床资料进行回顾性分析,包括手术暴露范围、肿瘤切除程度、激素水平的变化、神经血管的保护及出

神经外科常用评分/量表

格拉斯哥昏迷评分(GCS):     运动     6 - 按吩咐动作    5 - 对疼痛刺激定位反应    4 - 对疼痛刺激屈曲反应    3 - 异常屈曲(去皮层状态)    2 - 异常伸展(去脑状态)  

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