Macewen's sign 매퀴언 징후

[석수]

Macewen's sign

Macewen 징후 (Macewen sign)

→ ‘금 간 항아리 소리(cracked pot sign)’라고도 불림

이마뼈(frontal), 마루뼈(parietal), 비늘부 측두골(squamous temporal bone)이 만나는 두개골 접합 부위를 타진(percussion)하여 확인한다.

양성일 경우, 두드리면 공명하는 금 간 항아리 같은 소리가 난다.

대부분 영아의 수두증(hydrocephalus)과 연관되어 나타난다.

의학적으로는 두개골 봉합이 벌어져 있고 두개강 내 압력이 증가했을 때 나타나는 고전적인 임상 징후를 설명하는 그림입니다.

Macewen 징후 (Macewen’s sign)
= Crack pot sign(금 간 항아리 징후)

두개골을 타진(percussion)하여 유발된다.
한쪽에서 두개골을 두드리면, 반대쪽에 댄 청진기(stethoscope)로 증폭된 소리가 들릴 수 있다.

→ 이는 두개내 압력 증가로 인해 두개골 봉합(suture)이 벌어져 있음을 시사한다.
전천문(AF, anterior fontanelle)이 열려 있을 경우, 생리적으로도 나타날 수 있다.

즉, 이 징후는 주로 영아에서 두개내 압력 상승(예: 수두증)으로 인해 두개골 봉합이 분리되었을 때 나타나는 임상 소견을 설명하는 그림입니다



Macewen's sign, also known as the cracked-pot sign, is a clinical indicator of increased intracranial pressure, particularly in hydrocephalus, elicited by percussing the skull—typically at the junction of the frontal, temporal, and parietal bones—which produces a resonant, hollow sound resembling that of tapping on a cracked pot.[1] This sign results from the separation of cranial sutures due to fluid accumulation, allowing the skull to vibrate freely during percussion.

It was originally described as a diagnostic aid for hydrocephalus and brain abscesses in children and infants, where the thin, unfused skull bones enhance the auditory phenomenon.


Named after Sir William Macewen (1848–1924), a Scottish surgeon and pioneer in neurosurgery, the sign was first detailed in his 1893 monograph Pyogenic Infective Diseases of the Brain and Spinal Cord, where he reported using it successfully over a decade to localize and diagnose intracranial abscesses and tumors by detecting secondary hydrocephalus.

Macewen, based in Glasgow, integrated the sign into his innovative operative techniques, contributing to early advancements in brain surgery before the advent of antibiotics and imaging.


In clinical practice, the sign is most reliably positive in untreated congenital or acquired hydrocephalus when fontanelles are open or sutures are separated, but it may also appear in conditions like serous meningitis.

Though its diagnostic utility has diminished with the rise of computed tomography and magnetic resonance imaging, Macewen's sign retains educational value in neurology, illustrating the role of physical examination in assessing intracranial pathology