颅骨成形术后弥漫性脑肿胀一例报道及文献复习
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广州医科大学附属第二医院

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Massive brain swelling after cranioplasty: a case report and review of literature
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    【摘要】 目的 探讨颅骨成形术后弥漫性脑肿胀(MBSC)的临床特点 、发病机制及预防措施 。方法 回顾性分析1例MBSC患者的临床资料,并复习相关文献 。结果 患者男性,38岁,颅骨成形术后短时间内出现癫痫发作及瞳孔改变,头颅CT提示左侧大脑半球明显肿胀。经脱水、抗癫痫等治疗后,患者仍在术后72小时内死亡。结论 作为颅骨成形术的罕见并发症,MBSC多以瞳孔改变和癫痫发作为首发表现,病情进展快,死亡率极高 。术前改善颅骨凹陷状态,术中和术后避免脑脊液过度、过快流失及防止颅内压骤变是预防MBSC的关键。

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    Abstract: Objective To investigate the clinical manifestations, imaging features, pathogenesis and preventive treatment measures of diffuse brain swelling (MBSC) after cranioplasty. Methods The clinical data of a patient with MBSC were retrospectively analyzed. Results The patient was a 38-year-old male with seizures and pupillary changes within a short period of time after cranioplasty, and the cranial CT suggested significant swelling of the left cerebral hemisphere. The patient died within 72 hours postoperatively even after dehydration and antiepileptic treatment. Conclusion As a rare complication after cranioplasty, MBSC mostly has pupillary changes and seizures as the first manifestation, and the disease progresses rapidly, which seriously endangers the patient's life. Preoperative improvement of cranial depression, intraoperative and postoperative avoidance of excessive and rapid loss of cerebrospinal fluid and prevention of sudden changes in intracranial pressure are the keys to prevent the development of MBSC.

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  • 收稿日期:2021-12-15
  • 最后修改日期:2022-04-06
  • 录用日期:2022-05-05
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