颅骨骨折

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最后审阅: 10 Nov 2024
最后更新: 09 Apr 2021

小结

定义

病史和体格检查

关键诊断因素

  • 危险因素
  • 开放性骨折
  • 可触及的骨轮廓差异
  • 巴特尔体征
  • 眶周瘀斑
  • 血性耳漏
  • 脑脊液鼻漏
  • 面神经麻痹、眼球震颤或感觉异常
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其他诊断因素

  • 外伤证据
  • 颅痛或头痛
  • 恶心/呕吐
  • 精神状态变化/意识丧失
  • 瞳孔反射异常
  • 听力损失
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危险因素

  • 从高处跌落
  • 机动车辆事故
  • 导致头部外伤的殴打
  • 头部枪伤
  • 男性
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诊断性检查

首要检查

  • 颅脑 CT
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需考虑的检查

  • 骨骼检查
  • 磁共振成像 (MRI)
  • MR 血管造影术
  • β-2 转铁蛋白试验
  • 颅骨 X 光平片
  • 凝血筛查
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治疗流程

初步治疗

疑似颅骨骨折(任意类型)

急症处理

确诊闭合性非凹陷性骨折

确诊闭合性凹陷性骨折

确诊开放性骨折

持续性治疗

持续性颅神经损伤或脑脊液漏

撰稿人

专家顾问

Demetrios Demetriades, MD, PhD, FACS

Professor of Surgery

Director

Division of Trauma and Surgical Intensive Care

LAC+USC Trauma Center

Keck School of Medicine at USC

University of Southern California

Los Angeles

CA

利益声明

DD declares that he has no competing interests.

Leslie Kobayashi, MD, FACS

Associate Professor of Surgery

Division of Trauma, Surgical Critical Care and Burns

University of California San Diego

San Diego

CA

利益声明

LK declares that she has no competing interests.

同行评议者

Kevin Tsang, MBBS, BSc (Hons), MRCS (Eng), FRCS (SN)

Consultant Neurosurgeon

Unit Training Lead and Clinical Teacher

Imperial College Healthcare NHS Trust

London

UK

利益声明

KT declares that he has no competing interests.

编辑

Tannaz Aliabadi-Oglesby

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Jo Haynes

Head of Editorial, BMJ Knowledge Centre

利益声明

JH declares that she has no competing interests.

Annabel Sidwell

Comorbidities Editor, BMJ Best Practice

利益声明

AS declares that she has no competing interests.

Adam Mitchell

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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