背景:脑膨出是指脑膜和脑组织通过颅骨缺损突出。它是先天性的结果,创伤性,肿瘤,或自发的原因。创伤性脑膨出是由于颅骨创伤后骨折或医源性原因而发生的。表现差异很大,比如鼻漏,癫痫发作,头痛,和局灶性神经功能缺损.
方法:一名20岁的叙利亚男性到我们部门就诊,主诉右侧鼻孔引流脑脊液,它始于6年前的头部创伤,中度头痛,以及强直阵挛性癫痫发作,对药物治疗没有任何反应。然后,2个月前,病人患有脑膜脑炎,所以他被送进了重症监护室,治疗了一个月,直到痊愈。病人接受了放射学检查,这表明他有一个基础骨折,鼻腔有脑膨出。脑膜突出的脑组织通过颅底骨折突出,右半球蛛网膜下腔明显扩张。当时建议他接受手术修复,但他拒绝了手术.在这次访问中,显示手术。手术是由一位专家完成的,他将脑疝组织恢复到正常位置,修复了脑膜,用骨水泥和生物胶重建颅底。病人在手术后恢复顺利。
结论:创伤性脑膨出是一种罕见且意外的创伤并发症,但是当病人头部外伤时,我们应该记住这一点,因为它会危及生命。如果患者拒绝治疗,这种并发症可能会在多年的创伤后发生,因此,我们必须教育病人忽视脑脊液漏和颅骨骨折的危险结果。
BACKGROUND: Encephalocele refers to protrusion of the meninges and brain tissue through a skull bone defect. It results from congenital, traumatic, neoplastic, or spontaneous reasons. Traumatic encephalocele occurs because of the posttraumatic fracture of the skull bone or iatrogenic causes. The manifestations vary a lot, such as rhinorrhea, seizures, headaches, and focal neurological deficits.
METHODS: A 20-year-old Syrian male presented to our department with the complaint of clear cerebrospinal fluid drainage from his right nostril, which started 6 years ago after a head trauma, moderate headache, and episodes of tonic-clonic seizures without any response to medical treatment. Then, 2 months ago, the patient had meningoencephalitis, so he was admitted to the intensive care unit and treated for a month until he was cured. The patient underwent radiological investigations, which showed that he had a base fracture with an encephalocele in the nasal cavity. The brain tissues with the meninges herniated through the skull base fracture with a significant expansion of the subarachnoid spaces in the right hemisphere. He was advised to undergo surgical repair at that time, but he refused the surgery. During this visit, surgery was indicated. The surgery was done by a specialist who returned the herniated brain tissues to their normal location, repaired the meninges, and reconstructed the skull base with bone cement and bio-glue. The patient\'s recovery after the surgery was uneventful.
CONCLUSIONS: Traumatic encephalocele is a rare and unexpected complication of trauma, but we should keep it in mind when the patient comes with head trauma because of its life-threatening consequences. This complication can happen after years of trauma if the patient refuses treatment, therefore, we must educate patients about the dangerous results of neglecting cerebrospinal fluid leakage and skull fractures.