• Title/Summary/Keyword: Skull Fracture

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The Significance of 3-Dimensional Imaging in Tracheal Stenosis (기관협착증에서 3차원적 영상 진단의 의의)

  • 정동학;봉정표;이운우;노정래;성기준
    • Korean Journal of Bronchoesophagology
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    • v.1 no.1
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    • pp.82-93
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    • 1995
  • Three-dimensional reconstruction of computed tomographic image(3D CT) is a well-established imaging modality which has been investigated in various clinical settings. It is commonly performed in case of congenital or developmental abnormalities, and traumatic fracture of skull and face that requires reconstruction of osseous structure. However reporting the 3D CT in laryngeal or tracheal stenosis is rare and its results are obscure. The authors performed 3D CT in six cases of tracheal stenosis and found diagnostic value of 3D CT. A Comparision of diagnostic information obtained from plain X-ray, 2D CT and 3D CT has performed in total six cases of tracheal stenosis. Surgical treatment of the tracheal stenosis was following in these cases : tracheal end to end anastomosis In 1 case, laryngotracheal end to end anastomosis in 2 cases. 3D CT information was compared with operative finding. In two of six cases, satisfactory information was not obtained from 3D CT in evaluating an exact stenosis of trachea. Future, it will be helped in evaluating of tracheal stenosis by 3D CT.

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A Case of Delayed Intracerebellar Hematoma after Head Injury (두부외상 후 발생한 지연성 소뇌 혈종 1례)

  • Kim, Sahng Hyun;Whang, Kum;Pyen, Jin Soo;Hu, Chul;Hong, Soon Ki;Han, Young Pyo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.407-410
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    • 2000
  • The traumatically induced mass lesions of the posterior cranial fossa are unusual. Various types of traumatic posterior fossa hematoma have been described ; the most common forms is epidural hematomas, and frequently traumatic intracerebellar hemorrhage is encountered. A sixty-six-old male patient was initially presented with the occipital skull fracture and contusional hemorrhage on the both frontal lobe, a developed delayed cerebellar hemorrhage. The patient was operated for hematoma removal with good postoperative recovery. We advise a consideration for delayed intracerebellar hematoma in patients with cerebellar contusion following trauma.

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CAROTID-CAVERNOUS SINUS FISTULA ACCOMPANYING FACIAL BONE FRACTURE : Report of a Case (안면골 골절과 동반된 경동맥해면동루의 증례보고)

  • Park, No-Bu;Seo, Yeon-Ho;Moon, Seon-Hye;Lee, Yong-Oh
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.2
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    • pp.100-104
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    • 1993
  • Carotid-cavernous sinus fistula(CCSF) is an abnormal arterio-venous communication between the cavernous sinus and the internal carotid artery. It is usually caused by craniofacial trauma and a very rarely encountered complication, but it may also occur spontaneously. The most common cause of traumatic CCSF is blunt trauma, which usually associated with a skull base, frontal or midfacial fracture. The common clinical feature of CCSF are orbital bruit, headache, exophthalmos, chemosis, diplopia, visual disturbance and others. This dramatic ocular-orbital symptoms are principally due to orbital venous hypertension. The symptoms occured within a few hours to a maximum of a year after injury, usually within several weeks. The patient, 33-year-old female, developed a carotid-cavernous sinus fistula after only minimal closed trauma We present a rare case of CCSF associated facial bone fracture that was successfully treated by detachable balloon embolization with a review of the literature.

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Comparative study on the osseous changes of the TMJ and mandibular asymmetry after conservative or operative treatment in condylar fracture patients

  • Yu Su-Kyoung;Kim Kyung-A;Kwon Ki-Jeong;Koh Kwang-Joon
    • Imaging Science in Dentistry
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    • v.33 no.4
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    • pp.223-229
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    • 2003
  • Purpose: To compare the effects of the conservative treatment and operative treatment by observation of osseous changes of the TMJ and mandibular asymmetry in condylar fracture patients. Materials and Methods: 33 condylar fracture patients (17 with conservative and 16 with operative treatment) were included in this study. After a minimum of 6 months after the surgical procedure, patients were given a follow up examination of the osseous changes using a transcranial view. Differences in the osseous changes of both groups were compared and the asymmetry indices were calculated on a postero-anterior skull view. Results: The TMJ of the operative treatment group showed more significant osseous changes than the conservative treatment group. The affected TMJ showed more significant osseous changes than the unaffected TMJ in the both groups. The unaffected TMJ of the conservative group and the affected TMJ of the operative group showed significant osseous changes. The mandibular asymmetry indices in the conservative and operative group were 5.12 and 7.30 respectively at the time of treatment, and 2.39 and 3.41 respectively at the follow-up. But the mandibular asymmetry between the both groups showed no statistical differences. Conclusion: The TMJ of the operative group showed more significant osseous changes than the conservative group, but the mandibular asymmetry between the both groups showed no statistical difference.

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Chest Injuries due to Blunt Chest Trauma (둔좌상에 의한 흉부손상의 임상적 관찰)

  • Jin, Jae-Kwon;Park, Choo-Chul;Yoo, Seh-Young
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.418-423
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    • 1979
  • Chest injuries due to blunt trauma often result in severe derangements that lead to death. And we have to diagnose and treat the patients who have blunt chest trauma immediately and appropriately. A clinical analysis was made on 324 cases of chest injury due to blunt trauma experienced at department of Thoracic and Cardiovascular Surgery, College of Medicine, Kyung Hee University during 8-year period from 1972 to 1979. Of 324 patients of blunt chest injuries, there were 189 cases of rib fracture, 121 of hemothorax or/and pneumothorax, 108 of soft tissue injury of the chest wall only, 41 of lung contusion, 24 of flail chest, 13 of scapular fracture, 7 of diaphragmatic rupture and others. The majority of blunt chest injury patients were traffic accident victims and falls accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 3rd decade and 4th decade [60%] and 238 patients were male comparing to 86 of female [Male: Female = 3:1 ]. In the patients who have the more number of fractured ribs, the more incidence of intrathoracic injury and intraabdominal organ damage were found. The principal associated injuries were head injury on 58 cases, long bone fractures on 37, skull fractures on 12, pelvic fractures on 10, renal injuries on 6 and intraabdominal organ injuries on 5 patients. The principle of early treatment of chest injury due to blunt trauma were rapid reexpansion of the lung by closed thoracotomy which was indicated on 96 cases, but open thoractomy was necessary on 14 cases because massive bleeding, intrapleural hematoma and/or fibrothorax, or diaphragmatic laceration-On 15 cases who were young and have multiple rib fracture with severe dislocation delayed elective open reduction of the fractured ribs with wire was done on the purpose of preserving normal active life. The over all mortality was 2.8% [9 of 324 cases] due to head injury on 3 cases, massive bleeding on 2,wet lung syndrome, acute renal failure on 1 and septicemia on 1 patient.

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Treatment of an Occipital Fracture by Esquillectomy (골편적출술을 적용한 후두골 골절 치료)

  • Park, Jin-Uk;Cho, Ki-Rae;Chang, Dong-Woo;Choi, Seok-Hwa;Kim, Gon-Hyung
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.450-452
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    • 2010
  • A 4-year-old male Yorkshire terrier was referred to us with signs of vomiting and unconsciousness due to a blunt head trauma. Gross examinations detected facial edema, subcutaneous hemorrhage and hypersalivation. A survey radiograph located an occipital fragment which was displaced caudally. A three-dimensional computed tomographic reconstruction demonstrated that the ventral portion of the fragment was attached incompletely. Because of the instability of the fragment, it was decided to perform an esquillectomy. After removing the fragment, the defect was reinforced with a muscular flap originating from the splenius muscle. The patient's condition gradually improved except for a slightly ataxic gait. At 20 months follow-up, there was no evidence of ataxia. The neurological status did not deteriorate before starting surgical intervention, although the patient sustained a skull fracture with severe intracranial hemorrhage. It is likely that the fragment being displaced outwardly played an important role in preventing an increase in intracranial pressure which could have led to neurological deterioration.

A COMPARATIVE STUDY OF RADIOGRAPHIC IMAGINGS IN PATIENTS WITH MAXILLOFACIAL FRACTURES (상안면부 골절에 관한 방사선학적 비교 연구)

  • Hong Seong-Woo;Koh Kawng-Joon
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.25 no.2
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    • pp.545-553
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    • 1995
  • The subjects of this study consisted of 58 patients with Le Fort fractures, who were admitted to Chonbuk National University Hospital from Jan. 1988 to Oct. 1995. The author classified the maxillofacial fractures by Le Fort classification and examined the. incidence of Le Fort fractures by age, sex and etiology. The purpose of this study was to compare the imagings of conventional radiograms with those of computed tomograms and to aid in the diagnosis of patients with Le Fort fractures. The obtained results were as follows: 1. The Le Fort fractures occured mainly in 3rd and 4th decades, but there was no significant difference between decades. A ratio of men to women was 5.5 : 1. The major etiologic factors were traffic accident(69%), assault(14%) and fall-down(12%). 2. The most common type of Le Fort fracture was type I(49.3%). The numbers of Le Fort II, ill fractures were 41.3%, 9.4% respectively. And 8.6% were midsagittal splitting fractures. 3. The discontinuity and haziness of the maxillary sinus were easily detected by Waters' view. In skull PI A view, it was difficult to observe fractures due to overlapping of the other structures, but the haziness of the maxillary sinus was sometimes observed. 4. In Le Fort fracture, the fracture pattern of orbit, the wall of maxillary sinus, nasal bone and pterygoid plate were more easily detected in computed tomograms than in conventional radiograms.

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SUBMENTAL INTUBATION IN PANFACIAL TRAUMA PATIENT : A CASE REPORT (전안면골 외상 환자에서 턱밑 기관내 삽관에 대한 증례보고)

  • Seo, Dong-Jun;Kim, Nam-Kyun;Park, Se-Hyun;Kang, Yeon-Hee;Lee, Sung-Jin;Kim, Hyung-Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.6
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    • pp.604-607
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    • 2008
  • The technique of submental intubation in patient with multiple facial fracture and skull base fracture was originally described by Altemir. Not only is intermaxillary fixation feasible when using this surgical technique but a good field of vision is acquirable, and postoperative complications due to tracheostomy can be prevented. After Altemir presented submental intubation, many modified techniques were reported, applicable not only to trauma patients but also to elective surgeries such as orthognathic surgery including Lefort II or III osteotomy. This technique is easy to use, rapid and free of complications compared to alternative intubation method especially tracheostomy for multiple facial trauma patients.

The Clinical Usefulness of Halo Sign on CT Image of Trauma Patients (2세 미만 소아의 경도 두부 외상 후 두개골 골절 및 두개내 병변의 위험 인자)

  • Jeong, Jong Il;Kim, Ah Jin;Shin, Dong Wun;Rho, Jun Young;Kim, Kyung Hwan;Kim, Hong Yong;Park, Jun Seok
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.83-89
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    • 2007
  • Purpose: This research was performed to determine which clinical signs and symptoms of brain injury are sensitive indicators of skull fracture (SF) and intracranial injury (ICI) in head injured children. Methods: We conducted a prospective study of minor head trauma in children younger than 2 years of age for a 1-year period. Skull radiographs, brain computed tomography (CT), and data forms, including mechanism of injury, symptoms, physical findings, and hospital course, were completed for each child. Results: Of 137 study subjects, 17 (12.4%) had SF/ICI. Falls were the most common mechanism of injury, and heights of fall above 1 meter were associated with incidence of SF/ICI (p<0.05). Scalp abnormalities were not associated with incidence of SF/ICI. As for clinical symptoms, lethargy and a grouping of features (irritability & vomiting) were associated with incidence of SF/ICI (p<0.05). The incidence of seizure, loss of consciousness, vomiting, irritability, and scalp abnormality did not differ significantly between those with normal radiologic findings and those with SF/ICI. Among asymptomatic patients, 11 (14.5%) patients had SF/ICI, and among patients with normal scalp findings, 9 (12.7%) patients had SF/ICI. Conclusion: Clinical signs and symptoms, except for lethargy and a grouping of features (irritability & vomiting), were not sensitive predictors of SF/ICI. Nevertheless, SF/ICI occurred among normal children. In such a case, a liberal policy of CT scanning is warranted.

Craniofacial Deformity in a Patient with Dyke-Davidoff-Masson Syndrome: A Case Report (Dyke-Davidoff-Masson 증후군 환자의 두개골 변형: 증례보고)

  • Lee, Seung-Hyun;Lee, Hye-Kyung;Jeong, Hii-Sun
    • Archives of Craniofacial Surgery
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    • v.13 no.1
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    • pp.50-53
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    • 2012
  • Purpose: The Dyke-Davidoff-Masson syndrome is a rare disease entity that was first reported in 1993, and it is characterized by not only the cerebral hemiatrophy that is accompanied by the ipsilateral ventriculomegaly and ipsilateral compensatory osseous hypertrophy, but also the overgrowth of the paranasal sinuses. No studies have attempted to examine it from perspectives of the skull deformity and plastic surgery. Here, we report our case with a review of the literatures. Methods: A 45-year-old man with Dyke-Davidoff-Masson visited our medical institution with nasal bone fracture. Based on the previously taken brain MRI scans, we measured the degree of craniofacial deformity, and the horizontal distance, which is based on the margin of the skull, as well as the falx cerebri. Results: We made a comparison of the degree of craniofacial deformity. This showed that the mean horizontal distance on the axial view was shorter by approximately 28.46%, as compared with that of the left unaffected side. Conclusion: The Dyke-Davidoff-Masson is characterized by a concurrent presence of the atrophy of the cerebral hemisphere, with the cranial deformity. For the reconstruction of the bone and soft-tissue deformity with Dyke-Davidoff-Masson syndrome, it is needed to perform objective assessments.