cranial periosteal sinus
Introduction
Introduction to the skull periosteum The periosteal sinus of the skull is a vascular mass composed of no venous venous blood vessels that occur on or under the periosteum. The vascular mass communicates with the intracranial large sinus by a number of barrier veins and blood vessels of varying thickness. basic knowledge Sickness ratio: 0.001%-0.002% Susceptible people: no special people Mode of infection: non-infectious Complications: air embolism
Cause
Skull periosteal sinus
Disease factors (35%):
More common, due to congenital vascular dysplasia, chronic diseases of the skull, venous tumors or genetic defects caused by abnormal increase in the number of catheters, etc., due to cough, vomiting and other actions to cause venous rupture and other reasons, some Cases were accompanied by vascular abnormalities in other areas such as cavernous hemangioma or intracranial venous malformations, and individuals were also associated with congenital skull dysplasia.
Trauma factors (35%):
After head trauma, hematoma occurs under the periosteum, hematoma through the blood vessels and the intracranial sinus, or due to fracture of the skull outer surface, combined with coagulation mechanism and arachnoid granules deeper, thus promoting the occurrence of this disease, it is believed Skull fractures cause simultaneous abnormalities of extracranial abnormal blood vessels and venous sinuses, or due to skull fractures with venous tears and epidural hematoma, on which the disease occurs.
Prevention
Cranial periosteal sinus prevention
1) Develop good habits, quit smoking and limit alcohol consumption, the World Health Organization predicts that if people no longer smoke, after 5 years, the world's cancer will be reduced by 1/3. Second, don't drink alcohol. Smoke and alcohol are extremely acidic and acidic substances. People who smoke and drink for a long time can easily lead to acidic body.
2) Don't eat too much salty and spicy foods without eating overheated, cold, expired and degraded foods. Those who are frail or have a genetic disease of a certain disease can prevent brain tumors from eating some anti-cancer foods and alkaline foods with high alkali content as appropriate, and maintain a good mental state.
Complication
Cranial periostium sinus complications Complications, air embolism
Gas embolism may occur if air enters the sinus during surgery.
Symptom
Cranial periosteal sinus symptoms Common symptoms Swelling telangiectasia Skull fracture
Most patients can be asymptomatic. Some cases are only accidentally discovered. When the mass is enlarged, the local area may have a sense of swelling. Generally, a compressible soft mass can be seen on the scalp. There is no pulsation, and the local scalp can be reddish. Or bluish blue, sometimes on the surface of the scalp by small hemangiomas, telangiectasia or vasospasm. Any factor that increases intracranial pressure can enlarge the mass. When standing upright and sitting, the mass disappears. At the time, the compression of the bilateral jugular veins reappears. When lying on the back, prone or bow, the mass is significantly enlarged, and the pores or damage of the skull can be touched at the lesion.
Examine
Examination of the periosteum of the skull
No special performance.
X-ray examination, some visible local skull outer plate density is slightly lower and several sizes of bone holes, carotid angiography sometimes shows lesions, and direct puncture through the lesion can clearly show the lesion The whole appearance and drainage vein, the head CT showed that the lesion showed a slightly high density shadow, the local skull had different degrees of damage and defects, enhanced scanning, the lesion showed a significant enhancement effect, similar to the enhancement effect of the intracranial sinus, but sometimes due to Drainage vein stenosis or thrombus formation, but the enhancement response is not large, magnetic resonance scan see lesions as mixed signal, histological examination shows that the lesion is composed of many capillaries and dilated muscle-free veins.
Diagnosis
Diagnosis and identification of skull periosteal sinus
Diagnostic criteria
1. Clear history of trauma and significant scalp contusion or skull fracture.
2. The lesion is consistent with the injured part.
3. The lesion area showed no abnormality before the injury.
4. There is a time interval between the appearance of trauma and the mass.
5. Histological examination, the inner wall of the self-styled cavity has a relatively complete endothelium, while the traumatic type is lacking.
Differential diagnosis
Intracranial periosteal sinus must be differentiated from cavernous hemangioma, meningeal bulge, and dermoid cyst. The jugular vein can be used to judge whether it is the disease, that is, when the bilateral jugular vein is compressed, the mass is obviously increased, while other properties are observed. The above symptoms are almost absent from the tumor, and X-ray angiography, CT, and magnetic resonance imaging are helpful for further differential diagnosis.
