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- Abstract 文献概要
- 1ページ目 Look Inside
I.はじめに
外傷に伴う髄液鼻漏は,頭部外傷の1-3%に合併11,15,19)し,80-90%は,受傷後3ヵ月以内に発生1,12,17)している.
今回われわれは,受傷後10年目に髄膜炎で発症した外傷性髄液鼻漏の1例を経験したので,診断・治療について若干の文献的考察を加え報告する.
Abstract
In patients with head injury, the total incidence of CSF rhinorrhea was 1 - 3%, and in almost all cases, CSF rhinorrhea occurred within the first three months after injury. We report here a case of a 26 year-old male with CSF rhinorrhea manifested with meningitis who had once been admitted to hospital 10 years pre-viously with a head injury. He had a fracture which we thought had caused a CSF leakage in the left frontal skull base. After conservative treatment for a month we eventually undertook bifrontal craniotomy and repaired the cleft of the skull base with dura and fibrin.
In cases in which CSF rhinorrhea had occurred more than 10 years after head injury, including several re-ports in Japan, surgical treatment had always been re-quired. We think bifrontal craniotomy should be per-formed in such cases in which it is difficult to locate a cleft in the skull base before the operation. The field of view is wider during the intradural approach. To re-store an area with a lack of dura, highly anti-infectio-nary convexity dura is used a lot, and it is also thought that fibrin is effective in dural repair. The dural defi-cient areas take 3 to 4 months to repair perfectly, and postoperative observation of the patient's progress is required.

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