上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (9): 1181-.doi: 10.3969/j.issn.1674-8115.2010.09.040

• 病例报告 • 上一篇    

创伤性进展性后颅窝双侧硬脑膜外血肿一例报道

梁玉敏, 吴海波, 包映晖, 高国一, 江基尧   

  1. 上海交通大学 医学院附属仁济医院神经外科, 上海 200127
  • 出版日期:2010-09-25 发布日期:2010-09-27
  • 作者简介:梁玉敏（1962—）, 男, 主任医师, 博士；电子信箱: renjitora@sina.com。

One case report of traumatic progressive bilateral epidural hematomas of posterior cranial fossa

LIANG Yu-min, WU Hai-bo, BAO Ying-hui, GAO Guo-yi, JIANG Ji-yao   

  1. Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Online:2010-09-25 Published:2010-09-27

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摘要：

文章报道1例创伤性进展性后颅窝双侧硬脑膜外血肿病例。伤后1 h首次CT扫描示枕骨线形骨折伴薄层硬脑膜外血肿；于伤后14 h经再次CT检查确诊为后颅窝双侧跨幕上下进展性硬脑膜外血肿并引起梗阻性脑积水。病程中患者仅表现出头痛而无明显异常体征。急诊枕部旁正中切口入路手术清除血肿后，脑积水消失，患者恢复良好。文章结合文献，对该病例的相关问题进行探讨。

关键词: 颅脑创伤, 双侧硬脑膜外血肿, 后颅窝, 进展性出血

Abstract:

This paper reported a case of traumatic progressive bilateral epidural hematomas of posterior cranial fossa. The progressive bilateral hematomas which caused obstructive hydrocephalus were confirmed on second CT scanning 14 h after injury, which occurred in the impact location where only occipital linear fracture and thin epidural hematoma were seen on the initial CT scanning 1 h after injury. However, the patient only complained headache, and no abnormal neurological sign was found. The hydrocephalus disappeared after emergent evacuation of hematomas by occipital para-midline approach, and the patient had favourable recovery. On basis of literature review, some issues about this case were discussed in this paper.

Key words: traumatic brain injury, bilateral epidural hematoma, posterior cranial fossa, progressive hemorrhage