두 개저 골절없이 발생한 뇌실 기뇌증에 대한 증례보고

초록

목적: To report rare case of intracerebral pneumocephalus without the craniofacial fracture. 대상: the patient was experienced in pedestrian trafftic accident. The patient dis the lose consciousness. the patient sustained multiple contusion above the chest, head & all extremity. Ambulance rescued the patient from the bus. At that hospital, the patient began to complain of a headache, dyspnea and a chest discomfort. she vomited twice. Upon arrival the patient complained of headache & chest discomfort. She was alert and oriented. the past medical history was no significant for a traumatic brain injury. Examination revealed a multiple extensive air emphysema in masticator space, parapharyngeal space, retropharyngeal space, neck, face, and chest wall, both. Subcutaneous emphysema was severe conditions. Visual acuity was normal and the eye itself was intact. There was no facial bone tenderness. No Battle's sign or Raccoon eyes were noted. No rhinorrhea or hemotympanum were present. the neurologic examination was completely normal. A computed tomography(CT) scan of the head was ordered that revealed a extensive pneumocephalus and pneumoventricle, prompting transfer to our Emergency Medical Center. 결과 Clinically she did not have any evidence of skull fracture on 3mm CT cuts of craniofacial bones. The most significant finding in our patient was the extensive pneumocephalus & pneumoventricle present without an obvious fracture. 결론: Intraventricular pneumocephalus without the craniofacial fracture is a rare condition. We suggest that this condition can be caused minor fracture of skull base bone which has been not revealed in imaging study. But, we also suggest that pneumocephalus & pneumoventricle can be occured at several pathways in cerebrum without bony skull fracture.