小儿颅脑外伤后大面积脑梗塞例分析.doc

儿童颅骨骨膜窦12例的临床分析 黎开谷,梁 平,李映良,翟 瑄,周渝冬,李禄生,夏佐中(重庆400014，重庆医科大学附属儿童医院神经外科) [摘要] 目的 探讨儿童颅骨骨膜窦的临床特点及治疗。方法 将2000-2010年收治的12例儿童颅骨骨膜窦的临床资料结合文献进行回顾性分析。结果 无症状、可复性、中线附近的头皮下肿块为其典型临床表现；12例病例中，位于顶部4例（33.3％），额部3例（25.0％），枕部3例（25％），颞部2例（16.7％）。CT三维重建结论 儿童颅骨骨膜窦有典型的临床表现和影像学特征，手术切除可获得良好效果。 [关键词] 颅骨骨膜窦；诊断；手术；治疗；儿童 Sinus pericranii in children: clinical features and therapeutic considerations Li kai-gu, Liang ping, Li yingliang, Zhai xuan,Zhou yudong, Lilusheng , Xia Zuozhong (Department of Neurosurgery, Children Hospital of ChongQing Medical University，Chongqing, 400014,China) [Abstract] Objective To investigate the clinical features,therapeutic of sinus pericranii in children. Methods A retrospective review of 12 children with sinus pericranii pathologically confirmed by surgical resection was performed. Results The reach revealed 12 patients (9 males and 3 females).The lesion was located in the midline in 10 of 12 patients,and was parietal in 4 patients,and occipital in 3 patients,and frontal in 3 patients;in 2 patients was the lesion in a temporal off-midiline location. The characteristic feature of this abnormality is the dependence of its size on intracranial pressure and central venous pressure. All cases of sinus pericranii are of progressively enlarging tumors.Three-dimensional volume-rendered CT reconstruction (3D-CT) demonstrated multiple small diploic holes and erosion of the skull bone. The transcranial connection could be visualized using CT angiography (CTA) or MR venography(MRV). In all 12 cases in this study，we performed minimally invasive procedures of tumor excision, resection of the communication site by electrocoagulation，and bone wax and fibrin sealant filling of thesame site. The postoperative course was uneventful. All 12 patients were followed up.The follow-up outcome from 6 months to 5 years showed no relapse or any complications. Conclusion Sinus pericranii in children has typical clinical manifestations and imaging characteristics. The surgical resection can g