小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 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
其他诊断因素
- 外伤证据
- 颅痛或头痛
- 恶心
- 精神状态变化/意识丧失
- 瞳孔反射异常
- 听力受损
危险因素
- 男性
- 从高处跌落
- 机动车辆事故
- 导致头部外伤的殴打
- 头部枪伤
诊断性检查
首要检查
- 颅脑 CT
需考虑的检查
- 核磁共振成像 (MRI)
- MR 血管造影术
- β-2 转铁蛋白试验
- 听力敏度图
- 头颅超声
- 颅骨 X 光平片
- 骨骼检查
治疗流程
闭合性非凹陷型骨折
闭合性凹陷型骨折
开放性骨折
持续性颅神经损伤或脑脊液漏
撰稿人
作者
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
Tunji Lasoye, FRCS, FCEM, MA, Med Ed
Consultant and Honorary Senior Lecturer in Emergency Medicine
Clinical Lead
Emergency Department
Director of Medical Education
King's College Hospital
London
UK
利益声明
TL declares that he has no competing interests.
Micelle J. Haydel, MD
Program Director
LSU Emergency Medicine Residency
Louisiana State University
New Orleans
LA
利益声明
MJH declares that she has no competing interests.
Thomas Scalea, MD
Physician in Chief
R Adams Cowley Shock Trauma Center
Francis X. Kelly Professor of Trauma Surgery
University of Maryland School of Medicine
Baltimore
MD
利益声明
TS declares that he has no competing interests.
鉴别诊断
- 颅内出血
- 儿童缝线
- 头颅血肿
更多 鉴别诊断指南
- 头部损伤:评估和早期管理
- 儿童轻度创伤性脑损伤的诊断和管理指南
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