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Vol. 2. Issue 1.
Pages 17-24 (January 1991)
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Vol. 2. Issue 1.
Pages 17-24 (January 1991)
Traumatismos por aplastamiento bitemporal de cráneo. Un cuadro clínico característico
J. González Tortosa, M. Martínez Pérez, J.F. Martínez Lage, M. Poza
Servicio Regional de Neurocirugía. Hospital Virgen de la Arrixaca. Murcia
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Resumen

La inmensa mayoría de los TCE que se atienden en la práctica diaria, son traumatismos por aceleración/desacelaración del cráneo. En este trabajo resumimos toda nuestra experiencia con otro tipo de lesión mucho más rara: aquélla que se produce por una compresión progresiva bitemporal de la cabeza, sin componente rotatorio y que origina un cuadro clínico muy característico: ausencia de conmoción cerebral, epistaxis y otorragia bilateral, parálisis periférica del VI y VII pares craneales, fracturas de la base de cráneo, neumocéfalo y alteraciones del eje hipotálamohipofisario. Presentamos siete observaciones clínicas y una experimental, comprimiendo un cráneo en un tornillo de banco. Se revisa la bibliografía y discutimos la patogenia del cuadro clave.

Palabras clave:
Traumatismo de cráneo por aplastamiento
Fractura de base de cráneo
Pneumocéfalo
VI par
VII par
Diabetes insípida
Summary

Most head injuries are due to an acceleration mechanism. However, sorne of them are caused by progresive eompression of the skull, without a rotatory eomponent. That kind of mechanism brings about a very characteristic clinical picture when the compression is lateral: absence of concussion, nose and ear bleeding, palsy of the sixth and seventh cranial nerves and hypophyseal and hypothalamie disturbances. X-ray shows fracture of skull base and pneumoencephalus. We present seven cases and an experimental study, compressing the skull with a carpenter's clamp. Pathogeny is diseussed with review of literature.

Key words:
Crushing head injury
Basal skull fracture
Pneumocephalus
Abducens nerve
Facial nerve
Diabetes insipidus

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