두개골 골절, Skull fractures

두개골 골절, Skull fractures

두개골 골절의 개요, 종류, 증상, 징후, 진단, 치료

• 높은 곳에서 떨어지든지, 두부를 어디다가 세게 부딪치든지, 두부를 강타 당하든지, 교통사고나 그 밖에 다른 사고로 두부에 심한 외상을 입을 때 두개골이 골절될 수 있다. 
• 두개골 골절은 여러 가지의 형태로 생길 수 있다. 

• 두개골 골절의 종류, 중증도, 두개골 골절과 함께 생긴 다른 두부 외상 등의 유무와 정도에 따라 증상 징후가 다르다. 
• 출혈이 두개 강 내에 생기지 않고 금만 조금 간 경미한 선상 두개골 골절이 있을 때는 어지럽다든지, 머리가 조금 아프든지, 골절된 두개골의 바로 위에 있는 두피가 붓고 아플 수 있다. 
• 이런 증상 징후가 2~3일 정도 지나면 자연히 없어지고 두개골 골절도 자연히 계속 나는 것이 보통이다. 
• 드물게 두개 강 내 뇌척수 액이나 뇌 속 피가 골절된 두개골 골절의 뼈 틈을 통과해서 비강 속이나 외이도 속으로 흘러나올 수 있다. 
• 심한 두개골 골절과 뇌 실질 손상이 함께 있을 때는 혼수상태에 빠질 수 있다. 
• 두개골이 골절될 때 심한 두개 강 내 출혈이 있으면 생명에도 위험스럽다. 
• 병력·증상 징후·진찰소견 등을 종합하여 두개골이 골절됐다고 의심되면 두부 X선 사진·두부 CT 스캔 검사·두부 MRI 검사로 진단할 수 있다. 
• 두개골 골절의 종류와 중증도, 두개 강 내 출혈의 유무, 두피나 신체 다른 부위에 생긴 외상의 유무와 정도에 따라치료한다.

개방성 분쇄 함몰 두개골 골절은 즉각 골편 복위술로 치료한다. 

소아 단독 선상 두골 골절 Pediatric Isolated Linear Skull Fracture; 무딘  둔상으로 생긴 소아 단독 선상 두골 골절 있는 소아 환자에게  신경 황폐 증상이 생기지 않는 것이 보통이라고 한다. 2015년 5. NEJM , Journal Watch

Skull fractures두개골 골절

Overview, types, symptoms, signs, diagnosis, and treatment of skull fractures 

• The skull can be fractured when falling from a high place, hitting the head hard anywhere, hitting the head, or having severe trauma to the head in a car accident or other accident.
• Skull fractures can take many forms.

① Finely broken linear skull fracture like incontinence,

② As if a part of the ping-pong ball was crushed inward,

A depressed skull fracture in which part of the skull is broken into the two-cavity,

③ Depending on the part of the fractured skull, the upper skull fracture, the lower

skull (cranial base) fracture, or the skull

• There are several types of skull fractures, such as side fracture.
• Symptoms and signs differ depending on the type and severity of skull fractures, and the presence and severity of other head trauma associated with skull fractures.
• If there is a minor linear skull fracture with no bleeding in the cranial cavity and only a little crack, it may be dizzy, a little ache in the head, or the scalp just above the fractured skull may be swollen and sore.
• These symptoms disappear spontaneously after 2-3 days, and skull fractures usually continue to occur naturally.
• Rarely, intracranial cerebrospinal fluid or blood in the brain can pass through the bone gap of a fractured skull and flow into the nasal cavity or into the external ear canal.
• A combination of severe skull fractures and brain parenchymal damage can lead to coma.
• When a skull is fractured, severe intracranial bleeding is life-threatening.
• If you suspect that your child’s skull has been fractured by combining his medical history, symptoms, and medical findings,
• You can diagnose it with a head x-ray, a head CT scan, and a head MRI.
• It is treated according to the type and severity of skull fractures, the presence of intracranial bleeding, and the presence and extent of trauma to the scalp or other parts of the body.
• Open comminuted and indented skull fractures are treated immediately with bone fragment abdominal surgery.

Pediatric Isolated Linear Skull Fracture; It is said that it is usually not to develop neurological deterioration symptoms in a child patient who has a skull fracture on a single ship that looks like a blunt wound. 2015 5.NEJM, Journal Watch

출처 및 참조 문헌 Sources and references

• NelsonTextbook of Pediatrics 22ND Ed
• The Harriet Lane Handbook 22ND Ed
• Growth and development of the children
• Red Book 32^nd Ed 2021-2024
• Neonatal Resuscitation, American Academy Pediatrics

제12권. 소아청소년 신경 정신 질환, 행동 수면 문제

Emergency Medical Service for Children, By Ross Lab. May 1989. p.10
Emergency care, Harvey grant, and Robert Murray
Emergency Care Transportation of Sick and Injured American  Academy of Orthopaedic Surgeons
Emergency Pediatrics A Guide to Ambulatory Care, Roger M. Barkin, Peter Rosen
Quick Reference To Pediatric Emergencies, Delmer J. Pascoe, M.D., Moses Grossman, M.D. with 26 contributors
Manual of Emergency Care

응급환자관리 정담미디어
소아가정간호백과-부모도 반의사가 되어야 한다, 이상원 저
The pregnancy Bible. By Joan stone, MD. Keith Eddleman, MD
Preparation for Birth. Beverly Savage and Dianna Smith
임신에서 신생아 돌보기까지.  이상원
Breastfeeding. by Ruth Lawrence and Robert Lawrence
The Johns Hopkins Hospital, The Harriet Lane Handbook, 18th edition
Red book 29th-31st edition 2021
Nelson Text Book of Pediatrics 19th-21st Edition
Infectious disease of children, Saul Krugman, Samuel L Katz, Ann A. Gershon, Catherine Wilfert
The Harriet Lane Handbook 19th Edition
Growth and Development of Children, George H. Lowrey 8th edition
소아과학 대한교과서
제1권 소아청소년 응급의료 참조문헌과 출처
Other

Copyright ⓒ 2015 John Sangwon Lee, MD., FAAP

“부모도 반의사가 되어야 한다”-내용은 여러분들의 의사로부터 얻은 정보와 진료를 대신할 수 없습니다.

“The information contained in this publication should not be used as a substitute for the medical care and advice of your doctor. There may be variations in treatment that your doctor may recommend based on individual facts and circumstances. “Parental education is the best medicine.”