Cranial fissure
Introduction
Introduction to cranial tear Cranial fissure refers to the congenital defect of the skull; it occurs mostly in the occipital part of the skull, and the base of the nose and the bottom of the anterior cranial fossa are less common. The cranial fissure can be divided into two types: recessive and dominant. The former has only a simple skull missing, no bulge mass; the latter has a bulging cystic mass, so it is also called a cystic cleft, according to the contents of the mass. Can be divided into: (1) meningocele; (2) brain swelling; (3) meningeal brain swelling; (4) cerebral sac bulge; (5) meningeal sac bulge. The incidence of this disease is no difference between regions and men and women, but less than spina bifida, mainly for surgical treatment. The meningeal bulge and brain bulging in the recessive craniotomy and dominant craniotomy have a good prognosis and the rest are poor. basic knowledge The proportion of illness: 0.001%-0.003% Susceptible people: no special people Mode of infection: non-infectious Complications: brain atrophy
Cause
Cranial cleft cause
Congenital defects; more often occur in the occipital portion of the skull, the base of the nose and the bottom of the anterior cranial fossa are less common.
Prevention
Craniotomy prevention
1. First aid (mitigation measures): In recent years, due to the high brain pressure of severe head injury, the method of decompressing the bone flap is prevalent. Therefore, there are many artificial large skull defects. In fact, a considerable number of patients are Most of them do not need to perform large bone flap decompression, and most of them are decisions made during the surgery, and there are no defects.
2. Prevention of infection, symptomatic treatment and nutritional neurotherapy.
Complication
Craniofacial complications Complications brain atrophy
1. A large skull defect causes severe deformity of the patient's head, and over time, it will inevitably lead to local brain atrophy.
2. Children's skull defects can become larger with the development of brain tissue, the edge of the defect is turned outwards, and the protruding brain tissue is gradually progressive atrophy and cystic change, which affects normal brain development and has low intelligence; adults can Unresponsiveness, memory loss, and even focal neurological symptoms and signs.
Symptom
Craniofacial symptoms common symptoms double eyelid wide facial deformity headache brainache headache
1. There are no local and neurological symptoms in the recessive craniotomy, and skull defects are found only when the head X-ray is used for other reasons.
2. Dominant cranial fissure (also known as cystic cleft palate): The occipital midline or cystic bulge of the nasal root can be found at birth, and the surface can be covered with skin or film-like structure. If the bulge is pulsating or the tension is increased when the baby is crying, it means that it is connected to the brain. The meningeal bulge was positive for the light transmission test. With meningeal brain swelling, there is a shadow of brain tissue, and mental retardation.
3. In the occipital meningeal bulging, there may be visual impairment, bulging in the base of the nose, facial deformity may occur: the root of the nose widens the bulge, and the eye is squeezed to the sides, so that the pupil distance is widened.
Examine
Craniotomy
1. The skull X-ray photograph shows a round or elliptical skull defect in the midline of the skull.
2, skull computed tomography or skull MRI showed localized skull defects in the midline of the skull.
3. X-ray film: The position and extent of the skull defect can be displayed on the positive side and other plain planes.
4. CT scan: combined with X-ray film, not only can further clear the location and extent of the skull defect, but also can understand the surrounding skull and brain, brain bulging tissue, which is conducive to surgery.
Diagnosis
Diagnosis of craniotomy
Differential diagnosis
1. Local manifestations of skull defects
There is local pain, pain at the edge of the defect, unbearable brain pulsation, and the scalp is trapped in the skull when the defect is high. When the defect is low, the scalp even merges with some brain tissue and the ventricle bulges outward.
2. Skull Defect Syndrome
Mainly manifested as headache, dizziness, the patient's fear of pulsation, bulging and collapse of the defect area, fear of sun exposure, fear of vibration and even noise, often have poor self-control, difficulty in concentration and memory loss; or depression Tired, ignorant and inferior.
3. Long-term skull defect
When the brain bulges or protrudes, the brain tissue can shrink and become cystic. Children's skull defects become larger with the development of brain tissue, affecting normal brain development and low intelligence; adults may have unresponsiveness, memory loss and even focal neurological symptoms and signs. Meningeal-brain scar formation can be associated with epilepsy.
