Skull base deformity

Introduction

Introduction

The skull base deformity refers to a deformed lesion of the skull base including the skull base, the flat skull base, and the skull base depression. The main onset is certain genetic diseases or embryonic stages, caused by congenital bone dysplasia caused by external stimuli, or a small number may be secondary to other diseases. However, congenital skull base depression, often after the middle age, neurological symptoms gradually occur, usually after 20 to 30 years old, often caused by minor trauma, etc., causing damage to the brain stem or spinal cord. Children may also develop the disease.

Pathogen

Cause

The main onset of skull base deformity is caused by congenital bone dysplasia caused by external stimuli in some genetic diseases or embryos, or a few may be secondary to other diseases. However, congenital skull base depression often develops neurological symptoms after middle age, usually after 20 to 30 years of age, often caused by minor trauma, causing damage to the brain stem or spinal cord. At this time, even young children may develop disease, but most patients often develop symptoms due to aging, degeneration of the intervertebral joints and ligament relaxation.

Examine

an examination

Related inspection

Intracranial Doppler blood flow map (TCD) of the skull lateral radiograph

1. There is a short neck, a low hairline, a head and neck slant, and an asymmetrical auricle.

2, secondary nerve damage showed occipital neck pain, hoarseness or limb weakness, urinary retention, ataxia and paroxysmal vertigo.

3, increased intracranial pressure, manifested as headache, vomiting, binocular papilledema.

4, X-ray photographs of the occipital region (including fault slices) examination: the vertebral odontoids are 3mm higher than the occipital occipital line, the basal line is 9mm, and the second abdominal muscle groove is more than 12mm.

5, gas cerebral angiography, iodophenyl ester spinal canal angiography, computed tomography: contribute to the understanding of the ventricular system and the large hole area of the occipital bone. Magnetic resonance examination revealed that the cerebellar tonsils were found below the occipital foramen and the ventricles were enlarged.

Diagnosis

Differential diagnosis

Skull base deformities need to be distinguished from the following symptoms.

1, skull bottom syndrome:

(1) Symptoms of cervical nerve root irritation: pain in the pillow, loss of sensation, numbness in one or both upper limbs.

(2) Cranial nerve involvement symptoms: hoarseness, difficulty swallowing, unclear language, etc.

(3) Upper cervical spinal cord and medulla compression symptoms: limb weakness or paralysis, sensory disturbance, urinary retention, difficulty swallowing, etc.

(4) cerebellar symptoms: nystagmus, gait paralysis, Romberg's sign positive.

(5) vertebral artery blood supply disorders: sudden onset vertigo, visual impairment, vomiting and pseudobulbar paralysis.

2, skull base flat:

The diagnosis is mainly based on the measurement of the skull base angle (the angle formed by the saddle and the slope) according to the lateral slice of the skull. The angle between the lateral line of the skull and the center line of the saddle and the line connecting the center of the saddle to the forefoot of the large hole of the occipital region is formed. The normal value for adults is 109°-145° with an average of 132°. The cranial fossa, the base of the anterior cranial fossa and the slope of the skull base are all concave into the skull, which makes the skull base angle larger than 145°, which has diagnostic significance.

3. Skull bottom depression:

Skull base depression is easy to accumulate cerebellum, brainstem and vestibular function. It not only shows limb movement and sensory disturbance, ataxia, but also may have dizziness, nystagmus and symptoms and signs of cranial nerve damage in the fifth, ninth, tenth, and twelve, sexual dysfunction, sphincter dysfunction, and vertebral basilar artery blood supply. Insufficient clinical symptoms can also occur.

Decreased respiratory muscle function often makes the patient feel shortness of breath and speechlessness. In severe cases, different degrees of central respiratory depression and sleep dyspnea may occur.

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