著者

田代 弦 石崎 竜司

出版者

一般社団法人 日本小児神経外科学会

雑誌

小児の脳神経 (ISSN:03878023)

巻号頁・発行日

vol.46, no.1, pp.29-34, 2021 (Released:2021-03-31)

参考文献数

10

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鎖骨頭蓋形成不全症は,頭蓋骨欠損・鎖骨低形成,および歯牙の形成異常を三徴とする,常染色体優性遺伝疾患である.本稿では,自験例9例から診断年齢,頭蓋骨欠損の部位や大きさ,そしてその閉鎖時期などを解析し,その他の骨性合併症との対比を行った.また,日常生活上の脳神経外科的な対処法を加えながら,遺伝子学的病因論を交えて文献的考察とともに検証した.

著者

石崎 竜司 田代 弦

出版者

一般社団法人 日本脳神経外傷学会

雑誌

神経外傷 (ISSN:24343900)

巻号頁・発行日

vol.40, no.2, pp.92-95, 2017-12-20 (Released:2020-04-27)

参考文献数

7

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Background: There is an argument for the benefit of the helmet wearing at the time on a bicycle ride. We discuss the usefulness for head injury in traffic accident.Methods: We reviewed 13 cases, admitted to PICU in our hospital from April 2011 to April 2015, by traffic accident on a bicycle ride. We compared sex, age, conscious level and imaging findings between the cases with (A group) and without bicycle helmet (B group).Results: There was no significant difference in two groups about sex, age, and conscious level. However, more cases exist in B group as for skull fracture, brain contusion, and subcutaneous hematoma. On the other hand, A group had more cases suffered from the diffuse axon injury and subarachnoid hemorrhage.Conclusion: Helmet is effective to the direct injury of head, but might be little effective to the rotational injury.

著者

中嶋 広太 石崎 竜司 上村 紘也 田代 弦

出版者

一般社団法人 日本脳神経外傷学会

雑誌

神経外傷 (ISSN:24343900)

巻号頁・発行日

vol.44, no.2, pp.39-43, 2021-12-20 (Released:2021-12-20)

参考文献数

18

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An 8–year–old girl accidentally fell, and a pencil in her hand punctured the left temporal side of her skull. Her vital signs were normal at the time of transport to the previous hospital. Head computed tomography (CT) showed that the pencil had perforated from the left temporal side of her head to the left caudate nucleus, with hematoma along the perforating path, ventricular hematoma, traumatic subarachnoid hemorrhage, and subdural hematoma. Vascular evaluation using head CT angiography did not reveal any obvious main trunk vessel occlusion or injury. The patient was intubated and sedated to prevent the pencil from pulling out, and craniotomy was immediately performed to remove the pencil. The area of craniotomy was determined assuming right frontotemporal craniotomy, and the skin incision was made to include the pencil insertion site. The pencil was removed, and external decompression was performed to avoid cerebral edema. Postoperatively, the patient was managed in the pediatric intensive care unit. Prophylactic admin­istration of antimicrobials and anticonvulsants was initiated, and the patient did not develop signs of infection or convulsions. Postoperative follow–up imaging showed no traumatic intracranial aneurysm formation. After reduc­tion of brain swelling, cranioplasty was performed on postoperative day 23. Rehabilitation evaluation showed no obvious sequelae, and the patient was discharged to home on postoperative day 35. Although perforating head injuries in the temporal region are relatively rare, they more likely occur in children with soft skulls than in adults. For the treatment of perforating head trauma, it is important not to perform blind removal until surgical treatment. Preoperative assessment of vascular damage should be performed for decision making regarding the appropriate surgical treatment and postoperative management. Subsequently, it is important to confirm that there is no traumatic cerebral aneurysm formation.