• Title/Summary/Keyword: occipital fracture

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Clinical Study of Patient with Traumatic Temporal and Occipital Bone Fracture (외상성 후두골과 측두골 골절에 대한 고찰)

  • Park Min Cheol
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.5
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    • pp.1533-1537
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    • 2004
  • This study shows that oriental medical treatment affected a patient with headache, dizziness, dim eyes, facial palsy and hard-of-hearing caused by traumatic temporal and occipital bone fracture. Traumatic facial palsy mainly occures by temporal bone fracture. Facial palsy caused by traumatic temporal bone fracture corresponds to gu-an-wa-sha (口眼?斜)of oriental medicine. Functional disorder of an auditory organ corresponds to yi-rong(耳聾) and hyun-hoon(眩暈) of oriental medicine. In general, everyone consider surgical operation first of all, in the case of having traumatic facial nerve paralysis. But, this case shows that oriental medical treatments(acupuncture and herbal medicine) have a good effect on a patient with traumatic temporal and occipital bone fracture.

Sixth and Twelfth Cranial Nerve Palsies Following Basal Skull Fracture Involving Clivus and Occipital Condyle

  • Kim, Sung-Hoon;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • v.51 no.5
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    • pp.305-307
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    • 2012
  • Oblique basal skull fractures resulting from lateral crushing injuries involving both clivus and occipital condyle are rare due to their deep locations. Furthermore, these fractures may present clinically with multiple cranial nerve injuries because neural exit routes are restricted in this intricate region. The authors present an interesting case of basal skull fractures involving the clivus and occipital condyle and presenting with sixth and contralateral twelfth cranial nerve deficits. Clinico-anatomic correlations and the courses of cranial nerve deficits are reiterated. To the authors' knowledge, no other report has been previously issued on concomitant sixth and contralateral twelfth cranial nerve palsies following closed head injury.

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.

Three Dimensional Computed Tomography in the Assessment of Subtle Fracture in Dogs (컴퓨터단층촬영에서 3차원 재구성 영상을 통한 개의 골절 진단)

  • 이기창;권정국;송경진;최민철
    • Journal of Veterinary Clinics
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    • v.20 no.4
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    • pp.523-526
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    • 2003
  • Three dimensional computed tomographic images were obtained in two cases with trauma. The first case of a 3 year-old male Maltese, with ataxia and head tilting due to head trauma was referred to veterinary medical teaching hospital, Seoul National University. Remarkable findings were not found on survey radiographs. With the help of three-dimensional reconstruction computed tomographic imaging, parietal and occipital bone fracture was identified. The second case of 4 month-old female Yorkshire terrier with left forelimb lameness was referred right after trauma. Survey radiography showed obvious incongruity of the elbow joint. Lateral and medial condyle of the left humerus fracture and lateral displacement of the left ulna were apparent in three-dimensional computed tomographic image. It was considered that three-dimensional computed tomography could be used as an aid modality for the exact evaluation of extends and degree of fracture as well as planning of orthopedic surgery.

Posttraumatic Giant Extradural Intradiploic Epidermoid Cysts of Posterior Cranial Fossa: Case Report and Review of the Literature

  • Enchev, Yavor;Kamenov, Bogidar;William, Alla;Karakostov, Vasil
    • Journal of Korean Neurosurgical Society
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    • v.49 no.1
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    • pp.53-57
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    • 2011
  • We reported a unique case of posttraumatic giant infratentorial extradural intradiploic epidermoid cyst. A 54-year-old male, with a previous history of an open scalp injury and underlying linear skull fracture in the left occipital region in childhood, presented with a painful subcutaneous swelling, which had been developed gradually in the same region and moderate headache, nausea, vomiting and cerebellar ataxia. The duration of symptoms on admission was 3 months. Imaging studies revealed occipital bone destruction and giant extradural intradiploic lesion. The preoperative diagnosis was giant infratentorial extradural intradiploic epidermoid cyst. Surgery achieved total removal of the lesion, which was histologically confirmed and the postoperative course was uneventful. To our knowledge, this is the first case of giant infratentorial extradural intradiploic epidermoid cyst with a traumatic etiology described in the literature.

Early Spontaneous Recanalization of Sigmoid Sinus Thrombosis Following a Closed Head Injury in a Pediatric Patient : A Case Report and Review of Literature

  • Yun, Jung-Ho;Ko, Jung Ho;Lee, Mee Jeong
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.150-154
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    • 2015
  • Cerebral venous sinus thrombosis (CVST) following a closed head injury in pediatric patients is a rare condition, and an early spontaneous recanalization of this condition is extremely rare. A 10-year-old boy was admitted with a mild, intermittent headache and nausea five days after a bicycle accident. The brain computed tomography showed an epidural hematoma at the right occipital area with pneumocephalus due to a fracture of the occipital skull bone. The brain magnetic resonance imaging and the magnetic resonance venography demonstrated a flow signal loss from the right sigmoid sinus to the right jugular vein. The diagnosis was sigmoid sinus thrombosis, so close observations were selected as a treatment for the patient because of his gradually improving symptoms; however, he complained of vomiting 14 days the after conservative treatment. The patient was readmitted for a further examination of his symptoms. The laboratory and the gastroenterological examinations were normal. Due to concern regarding the worsening of the sigmoid sinus thrombosis, the brain magnetic resonance venography was rechecked and it revealed the recanalization of the venous flow in the sigmoid sinus and in the jugular vein.

Traumatic Intracerebellar Hematomas (외상성 소뇌내 혈종들)

  • Kim, Young-Dae;Park, Hyung-Ki;Chang, Jae-Chil;Cho, Sung-Jin;Choi, Soon-Kwan;Byun, Park-Jang
    • Journal of Korean Neurosurgical Society
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    • v.37 no.3
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    • pp.213-216
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    • 2005
  • Objective: We report six patients with traumatic intracerebellar hematomas between 1997 and 2003 at our hospitals. Methods: Each data about patients' clinicoradiologic findings, management, and outcomes, which were retrospectively reviewed. Results: All patients had skull fracture on occiput and five patients with large hematomas(three cm or greater) were operated on. In the results of surgery, three patients were good outcome but two patients were fatal due to compression of brain stem. One patient with small hematoma (1.5cm) was treated conservatively and recovered. Conclusion: In our cases, the clinical course and prognosis of traumatic intracerebellar hematoma were grave. The results of this study support that early diagnosis based on strict observation in patients with occipital fracture will lead to best results.

Posttraumatic Intracranial Tuberculous Subdural Empyema in a Patient with Skull Fracture

  • Kim, Jiha;Kim, Choonghyo;Ryu, Young-Joon;Lee, Seung Jin
    • Journal of Korean Neurosurgical Society
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    • v.59 no.3
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    • pp.310-313
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    • 2016
  • Intracranial tuberculous subdural empyema (ITSE) is extremely rare. To our knowledge, only four cases of microbiologically confirmed ITSE have been reported in the English literature to date. Most cases have arisen in patients with pulmonary tuberculosis regardless of trauma. A 46-year-old man presented to the emergency department after a fall. On arrival, he complained of pain in his head, face, chest and left arm. He was alert and oriented. An initial neurological examination was normal. Radiologic evaluation revealed multiple fractures of his skull, ribs, left scapula and radius. Though he had suffered extensive skull fractures of his cranium, maxilla, zygoma and orbital wall, the sustained cerebral contusion and hemorrhage were mild. Eighteen days later, he suddenly experienced a general tonic-clonic seizure. Radiologic evaluation revealed a subdural empyema in the left occipital area that was not present on admission. We performed a craniotomy, and the empyema was completely removed. Microbiological examination identified Mycobacterium tuberculosis (M.tuberculosis). After eighteen months of anti-tuberculous treatment, the empyema disappeared completely. This case demonstrates that tuberculosis can induce empyema in patients with skull fractures. Thus, we recommend that M. tuberculosis should be considered as the probable pathogen in cases with posttraumatic empyema.

Rod Migration into the Posterior Fossa after Harms Operation : Case Report and Review of Literatures

  • Chun, Hyoung-Joon;Bak, Koang-Hum;Kang, Tae-Hoon;Yi, Hyeong-Joong
    • Journal of Korean Neurosurgical Society
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    • v.47 no.3
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    • pp.221-223
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    • 2010
  • C1 lateral mass and C2 pedicle (C1LM-C2P) fixation is a relatively new technique for atlantoaxial stabilization. Complications from C1LM-C2P fixation have been rarely reported. The authors report unilateral rod migration into the posterior fossa as a rare complication after this posterior C1-C2 stabilization technique. A 23-year-old man suffered severe head trauma and cervical spine injury after vehicle accident. He was unconscious for 2 months and regained consciousness. He underwent C1LM-C2P fixation for stabilization of type II odontoid process fracture described by Harms. The patient recovered without a major complication. Twenty months after operation, brain computed tomogram performed at psychology department for disability evaluation showed rod migration into the right cerebellar hemisphere. The patient had mild occipital headache and dizziness only regarding the misplaced rod. He refused further operation for rod removal. To our knowledge, this complication is the first report regarding rod migration after Harms method. We should be kept in mind the possibility of rod migration, and C1LM-C2P fixation should be performed with meticulous technique and long-term follow-up.