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Severe Pneumocephalus after Penetrating Injury to the Lumbar Spine
並列摘要
Introduction: Pneumocephalus is air or gas located in the intracranial cavity. Head trauma is the most common cause of pneumocephalus, with the majority of cases resulting from sinus and basilar skull fractures. A small number of case reports have been published descrihing pneumocephalus after cervical and thoracic penetrating injuries. To our knowledge, we report the first case of severe pneumocephalus in a patient with multiple penetrating stab wounds to the lumbar spine. Case Report: A healthy 21-year-old male presented to the trauma service with multiple stab wounds to the chest and lumbar spine after being assaulted. Computed tomography scans demonstrated severe pneumocephalus and pneumorrhachis. The patient had neurological deterioration and repeat head scans revealed worsening pneumocephalus, Myelography revealed a cerebrospinal fluid leak and thus warranted neurosurgical intervention to repair a dural tear. The patient made a full recovery without any neurological sequelae. Conclusion: Pneurnocephalus caused by penetrating spinal trauma is exceedingly rare, especially to the lumbar spine and an extensive review revealed no cases in the literature. Our patient's mechanism of trauma along with his clinical symptoms and radiographic images led to his timely diagnosis, avoidance of tension pneumocephalus and allowed for the most appropriate interventions for a full neurological recovery. The common etiologies, symptoms, diagnostic methods and treatment options relevant to this case will be reviewed.
延伸閱讀
- Leung, H. B. (2003). Consequence of paraspinal muscle after posterior lumbar spinal fusion [master's thesis, The University of Hong Kong]. Airiti Library. https://www.airitilibrary.com/Article/Detail?DocID=U0029-1812201200001278
- 趙亮鈞、阮威勝、張哲肇、戴世煌、莊明宗、司君一、洪裕昌、李宜堅（2014）。Acute Paraparesis Caused by a Giant Cell Tumor of the Thoracic Spine。台灣癌症醫學雜誌，1(3)，260-266。https://doi.org/10.6323/JCRP.2014.1.3.11
- Chen, W. J., & Shih, C. H. (1988). Surgical Treatment of Lumbar Spinal Stenosis. Journal of Orthopaedic Surgery Taiwan, 5(2), 154-161. https://www.airitilibrary.com/Article/Detail?DocID=10116923-198806-5-2-154-161-a
- Takahashi, H., Wada, A., Terajima, F., Yokoyama, Y., Inoue, Y., Shibuya, K., Sasai, D., & Sekiguchi, M. (2013). Solitary Lumbar Spinal Osteochondroma Arising from the L3 Articular Process. Journal of Case Reports in Medicine, (2), 4-7. https://doi.org/10.4303/jcrm/235581
- Chen, C. L., Lee, C. H., Lee, T. S., Lin, Y. M., & Chen, Y. J. (2003). Spinal Epidural Lipomatosis with Thoracic Osteoporotic Compression Fracture Causing Paraplegia. Journal of the Formosan Medical Association, 102(6), 429-434. https://doi.org/10.29828/JFMA.200306.0013