Cervical pneumorrhachis caused by impact loading forces after skull base fracture: case report and review of the literature.

Central European Neurosurgery Pub Date : 2011-11-01 Epub Date: 2010-06-09 DOI:10.1055/s-0030-1252008
G Bozkurt, C C Turk, S Ayhan, A Akbay, S Palaoglu
{"title":"Cervical pneumorrhachis caused by impact loading forces after skull base fracture: case report and review of the literature.","authors":"G Bozkurt, C C Turk, S Ayhan, A Akbay, S Palaoglu","doi":"10.1055/s-0030-1252008","DOIUrl":null,"url":null,"abstract":"Bozkurt G et al. Cervical Pneumorrhachis caused by Impact Loading Forces ... Cen Eur Neurosurg 2011; 72: 215 – 218 Introduction ▼ The presence of air in the spinal canal is referred to as pneumorrhachis (PR). The proposed causes of PR are iatrogenic, non-traumatic, and traumatic [7, 14] . Air in the spinal canal may be extradural (epidural) or intradural (subdural and subarachnoid) and is found in an isolated form at the cervical, thoracic, and lumbosacral levels or as a diff use form in the entire spinal canal [14] . Traumatic PR can be also classifi ed as intradural (subdural or subarachnoid) or extradural (epidural) and is associated with diff erent pathophysiologic mechanisms and causes [7, 14] . In general, the occurrence of air within the epidural space is more common than intradural PR. The presence of epidural air has a diff erent implication from subarachnoid PR. Epidural PR is usually benign, innocent, asymptomatic, resolves spontaneously and is usually localized to a fracture line [7, 14] . The underlying cause should be treated. Traumatic subarachnoid PR is secondary to major trauma, and usually accepted as an indirect sign of severe injury. Traumatic subarachnoid PR, which is almost always associated with pneumocephalus, needs more detailed investigation, close monitoring, and follow-up because air in the subarachnoid space may lead to increased or decreased intracranial and intraspinal pressure as it moves up or down, resulting in neurological signs and symptoms [22] and even mortality [3, 16] . The management of subarachnoid air is not just limited to the underlying cause. Potential complications such as persistent pneumocephalus and infection associated with subarachnoid PR should be prevented and, if necessary, the torn dura should be repaired. Although a head or face-down position with the patient in a horizontal position during the accident is an important mechanism of cervical PR formation after head trauma and / or skull base fracture, the importance of the degree and severity of the impact has not been reported previously [1 – 3, 7 – 10, 13 – 16, 20, 22] . To the best of our knowledge, only fourteen cases of isolated traumatic cervical intradural PR secondary to open skull fracture and skull base fracture have been reported in the literature [1 – 3, 7 – 10, 13 – 16, 20, 22] . We performed a review of the comprehensive literature of the U. S. National Library of Medicine ’ s Medline bibliographic database to compare the diff erent mechanisms of injury proposed for this kind of lesion. In this case report, its clinical importance is also discussed.","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0030-1252008","citationCount":"4","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Central European Neurosurgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1055/s-0030-1252008","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2010/6/9 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 4

Abstract

Bozkurt G et al. Cervical Pneumorrhachis caused by Impact Loading Forces ... Cen Eur Neurosurg 2011; 72: 215 – 218 Introduction ▼ The presence of air in the spinal canal is referred to as pneumorrhachis (PR). The proposed causes of PR are iatrogenic, non-traumatic, and traumatic [7, 14] . Air in the spinal canal may be extradural (epidural) or intradural (subdural and subarachnoid) and is found in an isolated form at the cervical, thoracic, and lumbosacral levels or as a diff use form in the entire spinal canal [14] . Traumatic PR can be also classifi ed as intradural (subdural or subarachnoid) or extradural (epidural) and is associated with diff erent pathophysiologic mechanisms and causes [7, 14] . In general, the occurrence of air within the epidural space is more common than intradural PR. The presence of epidural air has a diff erent implication from subarachnoid PR. Epidural PR is usually benign, innocent, asymptomatic, resolves spontaneously and is usually localized to a fracture line [7, 14] . The underlying cause should be treated. Traumatic subarachnoid PR is secondary to major trauma, and usually accepted as an indirect sign of severe injury. Traumatic subarachnoid PR, which is almost always associated with pneumocephalus, needs more detailed investigation, close monitoring, and follow-up because air in the subarachnoid space may lead to increased or decreased intracranial and intraspinal pressure as it moves up or down, resulting in neurological signs and symptoms [22] and even mortality [3, 16] . The management of subarachnoid air is not just limited to the underlying cause. Potential complications such as persistent pneumocephalus and infection associated with subarachnoid PR should be prevented and, if necessary, the torn dura should be repaired. Although a head or face-down position with the patient in a horizontal position during the accident is an important mechanism of cervical PR formation after head trauma and / or skull base fracture, the importance of the degree and severity of the impact has not been reported previously [1 – 3, 7 – 10, 13 – 16, 20, 22] . To the best of our knowledge, only fourteen cases of isolated traumatic cervical intradural PR secondary to open skull fracture and skull base fracture have been reported in the literature [1 – 3, 7 – 10, 13 – 16, 20, 22] . We performed a review of the comprehensive literature of the U. S. National Library of Medicine ’ s Medline bibliographic database to compare the diff erent mechanisms of injury proposed for this kind of lesion. In this case report, its clinical importance is also discussed.
颅底骨折后冲击载荷引起的颈椎气痛:病例报告及文献复习。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Central European Neurosurgery
Central European Neurosurgery CLINICAL NEUROLOGY-NEUROSCIENCES
自引率
0.00%
发文量
0
审稿时长
>12 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信