• 제목/요약/키워드: Skull fracture

검색결과 102건 처리시간 0.023초

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

  • 정동학;봉정표;이운우;노정래;성기준
    • 대한기관식도과학회지
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    • 제1권1호
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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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두부외상 후 발생한 지연성 소뇌 혈종 1례 (A Case of Delayed Intracerebellar Hematoma after Head Injury)

  • 김상현;황금;변진수;허철;홍순기;한용표
    • Journal of Korean Neurosurgical Society
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    • 제29권3호
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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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안면골 골절과 동반된 경동맥해면동루의 증례보고 (CAROTID-CAVERNOUS SINUS FISTULA ACCOMPANYING FACIAL BONE FRACTURE : Report of a Case)

  • 박노부;서연호;문선혜;이용오
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제15권2호
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    • pp.100-104
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    • 1993
  • 저자들은 두개저 골절을 동반하지 않은 단순 안면골 골절환자에서 본과에서 안면골 정복 수술후 발현한 외상성 경동맥해변동루 환자를 신경외과에 의뢰하여 분리풍선술식으로 처치한 후 현저한 임상적 증상의 개선을 가져왔고 12개월간 관찰시 다른 합병증도 유발되지 않았다. 외상성 경동맥해면동루는 두경부 손상시 매우 드물게 발생되는 심각한 합병증으로 임상증상의 복잡성 때문에 혼동하기 쉬으므로 Neurosurgeon과 협조하여 조기에 정확한 진단과 적절한 치료가 이루어지는 것이 바람직하다.

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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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    • 제33권4호
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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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둔좌상에 의한 흉부손상의 임상적 관찰 (Chest Injuries due to Blunt Chest Trauma)

  • 진재권;박주철;유세영
    • Journal of Chest Surgery
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    • 제12권4호
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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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골편적출술을 적용한 후두골 골절 치료 (Treatment of an Occipital Fracture by Esquillectomy)

  • 박진욱;조기래;장동우;최석화;김근형
    • 한국임상수의학회지
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    • 제27권4호
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    • pp.450-452
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    • 2010
  • 4년령의 수컷 요크셔테리어가 두부의 둔상에 의한 구토와 무의식을 주증으로 내원하였다. 육안검사에서 안면 부종, 피하 출혈, 과유연을 확인하였다. 방사선 검사에서 후두골편이 뒤쪽으로 변위되어 있음이 확인되었다. 3차원으로 재구성한 컴퓨터단층촬영 영상에서 골편의 배쪽 부분이 불완전하게 부착되어 있음을 보여주었고, 골편의 불안정성 때문에 골편적출술을 실시하기로 결정하였다. 골편의 제거 후, 결손부는 널판근을 이용한 근육판으로 보강하였다. 환자 상태는 약간의 실조성 보행을 제외하고, 점차 개선되었다. 술 후 20개월째 추적조사에서 운동실조는 더 이상 관찰되지 않았다. 심한 두 개 내 출혈과 두개골 골절에도 불구하고, 수술적인 중재를 시작하기까지 환자의 신경학적인 상태는 심하게 악화되지는 않았다. 이는 바깥쪽으로 변위된 골편이 신경학적 악화를 야기할 수 있는 두개내압의 증가를 방지하는데 주요한 역할을 했기 때문이라고 사료된다.

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

  • 홍성우;고광준
    • 치과방사선
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    • 제25권2호
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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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전안면골 외상 환자에서 턱밑 기관내 삽관에 대한 증례보고 (SUBMENTAL INTUBATION IN PANFACIAL TRAUMA PATIENT : A CASE REPORT)

  • 서동준;김남균;박세현;강연희;이성진;김형준
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제30권6호
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    • pp.604-607
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    • 2008
  • 턱밑 기관내 삽관술은 기본적인 수술적 술기가 필요하지만, 간단하고 안전하며 술식이 빠른 장점을 가지고 있다. 또한 술 중 악간 고정이 가능하며, 수술 시야를 확보할 수 있으며, 술 후 합병증이 적고 기관절개술로 인한 부작용을 줄일 수 있다는 장점을 가지고 있다. 따라서 기본적인 술기의 습득과 마취과와의 협조가 동반된다면 많은 분야에서 사용 될 수 있는 방법이라고 생각된다.

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

  • 정종일;김아진;신동운;노준영;김경환;김홍용;박준석
    • Journal of Trauma and Injury
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    • 제20권2호
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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.

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

  • 이승현;이혜경;정희선
    • 대한두개안면성형외과학회지
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    • 제13권1호
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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.