skull defect
Introduction
Introduction to skull defect Skull defect refers to a series of clinical symptoms caused by open brain injury, firearm penetrating injury and other skull defects. It is a common sequelae of patients with craniocerebral injury after injury and postoperative. Because the brain tissue loses the barrier function of normal skull and is easy to be injured, and the skull defect can cause various symptoms and affect the appearance, it is often necessary to perform cranioplasty. basic knowledge Sickness ratio: 0.0001% Susceptible people: no specific population Mode of infection: non-infectious complication:
Cause
Cause of skull defect
(1) Causes of the disease
Skull defects can be seen in:
1. Open craniocerebral injury, especially after debridement of firearm wounds, the skull itself has fractures and fragments, and the wound is a bacterial open wound, which is easy to be infected and the fracture cannot be reset.
2. Closed head injury to clear the hematoma, the intracranial pressure is still high after the brain tissue is infested, and the decompressive craniectomy is performed.
3. After the removal of skull disease and other skull lesions.
The skull is a membranous bone with poor regeneration ability. The new bone is mainly from the inner periosteum, and the bone regeneration ability is lost after 5 to 6 years old. The diameter less than 1 cm can be bone healing, and the diameter of 2 to 3 cm or more is difficult to repair. Remaining skull defects.
(two) pathogenesis
Usually the skull defect is less than 3cm, more asymptomatic; after the subcondylar decompression or suboccipital decompression, there are thick muscles and fascia covering and can form a tough fibrous healing layer in the defect area. The protective effect of the skull on the brain has no symptoms in the clinic. Large skull defects can cause severe deformity of the patient's head, which directly affects the physiological balance of the intracranial pressure. It collapses when standing upright, bulges when lying down, is concave in the morning, and protrudes at night. Or because the atmospheric pressure directly acts on the brain tissue through the defect area, over time, it will inevitably lead to local brain atrophy, aggravating the symptoms of brain damage, and at the same time, the affected ventricle is gradually expanding or deforming into the defect area. In addition, the skull defect of the child can be As the brain tissue develops, the edge of the defect turns outwards, and the protruding brain tissue gradually undergoes progressive atrophy and cystic changes. Therefore, the child needs a complete skull to ensure the normal development of the brain.
Prevention
Skull defect prevention
In recent years, due to the high brain pressure of severe craniocerebral injury, the decompressive method of decompressive craniectomy is prevalent, so there are many artificial large skull defects. In fact, a considerable number of patients do not need large cranial decompression. Most of them are decisions made during the surgery, and there are no defects.
Complication
Skull defect complications Complication
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 gradually undergoes progressive atrophy and cystic changes, which affects the normal development of the brain.
Symptom
Skull Defect Symptoms Common Symptoms Responding to Dizziness and Melancholy
Usually the skull defect is less than 3cm, more asymptomatic; after the subcondylar decompression or suboccipital decompression, there are thick muscles and fascia covering and can form a tough fibrous healing layer in the defect area. The protective effect of the skull on the brain is clinically free of any symptoms. Defects with a diameter of more than 3 cm, especially those that are obstructive to the appearance and safety of the forehead, often have symptoms of one kind or another.
1. The local manifestations of the skull defect have 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 manifests as headache, dizziness, patient's pulsation in the defect area, bulging, collapse, fear, sun exposure, fear of vibration or even noise, often have poor self-control, difficulty to concentrate and Memory loss; or depression, fatigue, ignorance and low self-esteem.
3. When the long-term skull defect has brain swelling or protrusion, the brain tissue can be atrophied and cystic. The skull defect of the child becomes larger with the development of the brain tissue, which affects the normal brain development and has low intelligence; the adult may have unresponsiveness and memory. Decreased or even focal neurological symptoms, signs, meningeal-brain scar formation may be associated with epilepsy.
Examine
Skull defect examination
1. X-ray plain film positive lateral position and other different orientation plain film can display the location and extent of the skull defect.
2. CT scan combined with X-ray film can not only further clarify the location and extent of skull defect, but also understand the surrounding skull and brain, brain bulging tissue, which is conducive to surgery.
Diagnosis
Diagnosis and diagnosis of skull defect
The local clinical manifestations of typical defects, combined with X-ray plain film, CT scan, can be clearly diagnosed.
