在前额鼻腔骨折患者中创伤性脑损伤
Pharibe Pope1, Bashar Hassan2, Kimberly Oslin1
1University of Maryland School of Medicine.
The Journal of craniofacial surgery
|June 28, 2024
概括
创伤性脑损伤 (TBI) 在前额骨折中很常见,特别是在前后骨折中. 许多患者经历了持续的神经问题,强调了在这些情况下需要高度怀疑和成像.
科学领域:
- 神经外科 神经外科
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
背景情况:
- 创伤性脑损伤 (TBI) 是神经障碍的一个重要原因.
- 额头鼻腔骨折与TBI的高发病率有关,但风险因素尚未得到充分研究.
- 了解这些风险对于及时诊断和管理至关重要.
研究的目的:
- 评估前额骨折患者出现TBI的患病率.
- 在这个患者群体中识别TBI和持续的神经系统后续的风险因素.
- 为临床实践提供有关诊断和随访的信息.
主要方法:
- 2019年对前额骨折患者的回顾性评估.
- 根据神经症状,征兆或格拉斯哥昏迷尺度<15.5的定义TBI.
- 利用双变量分析和多变量逻辑回归来识别风险因素.
主要成果:
- 82.1%的前额骨折患者同时患有TBI.
- 前和后骨折的组合显著增加了TBI的几率 (aOR 12.7).
- 70.6%的人经历了持续的神经后果;轨道顶部骨折增加了后果的几率 (aOR 32).
结论:
- 额头鼻腔骨折中TBI的高患病率需要保持警.
- 桌面骨折和轨道屋顶骨折的组合是TBI和后果的关键指标.
- 建议对高风险患者进行头部CT和密切的神经随访.
相关概念视频
Brain Abscess l: Introduction
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
Traumatic Brain Injury l: Introduction
DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...


