안와경유 두개내 관통상에 의한 대량의 지주막하 기뇌증: 증례 보고

Massive Subarachnoid Pneumocephalus due to Transorbital Intracranial Penetrating Injury: A Case Report

  • 곽순혁 (충북대학교 의과대학 영상의학과학교실) ;
  • 이승영 (충북대학교 의과대학 영상의학과학교실) ;
  • 차상훈 (충북대학교 의과대학 영상의학과학교실) ;
  • 강민호 (충북대학교 의과대학 영상의학과학교실) ;
  • 조범상 (충북대학교 의과대학 영상의학과학교실) ;
  • 한기석 (충북대학교 의과대학 영상의학과학교실) ;
  • 박길선 (충북대학교 의과대학 영상의학과학교실) ;
  • 김성진 (충북대학교 의과대학 영상의학과학교실)
  • Kwak, Soon-Hyuk (Department of Radiology, College of Medicine, Chungbuk National University) ;
  • Lee, Seung-Young (Department of Radiology, College of Medicine, Chungbuk National University) ;
  • Cha, Sang-Hoon (Department of Radiology, College of Medicine, Chungbuk National University) ;
  • Kang, Min-Ho (Department of Radiology, College of Medicine, Chungbuk National University) ;
  • Cho, Bum-Sang (Department of Radiology, College of Medicine, Chungbuk National University) ;
  • Han, Gi-Seok (Department of Radiology, College of Medicine, Chungbuk National University) ;
  • Park, Kil-Sun (Department of Radiology, College of Medicine, Chungbuk National University) ;
  • Kim, Sung-Jin (Department of Radiology, College of Medicine, Chungbuk National University)
  • 발행 : 2011.11.01

초록

안와를 경유하는 두개내 손상은 드문 관통상으로 안와와 대뇌구조에 심각한 손상을 초래할 수 있다. 저자들은 53세 여성에서 발생한 안와경유 관통상에 의한 대량의 지주막하 기뇌증의 증례를 보고한다. 환자는 내원 1시간 전 화분의 화초 고정용 철사에 왼쪽 눈을 찔린 후 본원으로 내원하였다. 이학적 검사에서 안와 주변 연부조직손상 외에 신경학적 이상은 없었다. 전산화단층촬영에서 소량의 두개강 내 출혈을 동반한 대량의 지주막하 기뇌증이 보였으며 기포화 된 침상돌기의 골절이 있었다. 10일 후 시행한 두부전산화단층촬영에서 기뇌증은 소실되었고 환자는 합병증 없이 회복되었다.

A transorbital intracranial injury is a rare penetrating injury that can cause severe damage to orbital and cerebral structures. We report the case of a 53-year-old woman with massive subarachnoid pneumocephalus caused by a transorbital penetrating injury. She presented to our hospital with ocular pain after she accidently pierced her left eye with a steel wire while fixing a plant in a pot. A physical examination did not show any neurologic deficit. A brain CT showed a massive subarachnoid pneumocephalus with minimal intracranial hemorrhage and a 3D-reconstructed CT image showing a fracture at the pneumatized anterior clinoid process. A follow-up brain CT scan performed 10 days later revealed that the pneumocephalus and intracranial hemorrhage had completely resolved. The patient recovered without any complications.

키워드

참고문헌

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