论文部分内容阅读
目的：探讨颅底凹陷症及颅底凹陷症合并寰枕融合畸形的病理机制。资料与方法：本文分析７２例颅底凹陷症及１００例正常人的ＣＴ表现。结果：病理组单纯颅底凹陷症２９例，伴寰枕融合者４３例，寰枕高度小于３１ｍｍ者３２例，其中寰椎发育不良短小者１３例，枕骨髁发育不良短小者２４例，二者同时存在者６例；寰枕高度大于３１ｍｍ者１１例。寰枢椎脱位１８例，其中枕骨髁发育不良短小者２例，合并寰椎发育不良短小者１５例，仅一例脱位甚轻者为单纯颅底凹陷症。横韧带断裂１１例，全部合并寰椎发育不良短小，齿状突凸入枕大孔者９例，均合并寰椎发育不良。结论：作者认为：单纯颅底凹陷症及颅底凹陷症合并枕骨髁发育不良的主要病理改变为延、颈髓屈曲后弓并与小脑扁桃体相互挤压。颅底凹陷症合并寰椎发育不良的病理机制为齿状突对脑干腹侧面的直接压迫及小脑扁桃体对脑干背侧面的压迫
Objective: To explore the pathological mechanism of skull base depression and skull base depression with atlanto-occipital fusion deformity. Materials and Methods: This paper analyzes 72 cases of skull base depression and 100 cases of normal CT. Results: There were 29 cases with simple skull base depression in the pathological group, 43 cases with atlanto-occipital fusion, 32 cases with atlanto-occipital height less than 31 mm, including 13 cases with atypical atypical ataxia and 24 cases with hypoplasia of occipital condyles There were 6 cases at the same time; 11 cases with atlanto-occipital height greater than 31mm. There were 18 cases of atlantoaxial dislocation, including 2 cases with poorly developed occipital condyles and 15 cases with short congenital atlas. Only one case with slight dislocation was simple skull base depression. Transverse ligament rupture in 11 cases, all combined with atlas dysplasia was short, odontoid protrusion into the occipital hole in 9 cases, were associated with atlas dysplasia. Conclusion: The author believes that the main pathological changes of simple skull base depression and skull base depression with hypoplasia of the occipital condyles are delayed. The cervical spinal cord is flexed and then compressed with the cerebellar tonsils. Pathological mechanism of skull base depression with atlas dysplasia is the direct compression of the dentate process on the ventral surface of the brainstem and the oppression of cerebellar tonsils on the dorsal surface of the brainstem