创伤性后颅窝血肿的临床特点及救治体会

Clinical feature and treatment of traumatic hematoma of the posterior fossa

目的 探讨创伤性后颅窝血肿的临床特点及救治方法。方法 对我科2000-01～2005-06期间收治的创伤性后颅窝血肿忠者51例的临床资料进行分析，根据后颅窝血肿的病情及出血量的多少而采取保守治疗或手术治疗。结果 51例患者中，保守治疗12例，恢复良好11例，死亡1例；手术治疗39例，恢复良好31例，伤残4例，死亡4例。结论 创伤性后颅窝血肿有着不同于幕上创伤性颅内血肿的临床特点，意识障碍较轻，小脑受顿的特异性症状如眼球水平震颤、共济失调等较少见，而头痛、呕吐、躁动不安等非特异性症状较多见，易直接发生枕骨大孔疝。严密观察及动态CT检查，及时抓住手术时机，可有效降低致残率及死亡率。

Objective To investigate the clinical feature and treatment of traumatic hematoma of the posterior fossa. Methods The clinical data of 51 patients, admitted from January 2000 to June 2005 after different treatment which depend on the clinical condition and hematoma amount, were analyzed. Results Of 51 patients , 12 patients received conservative treatment , 39 patients were underwent operation. Of 12 patients, 11 patients got good recovery , 1 patient died . Of 39 patients,31 patients got good recovery, 4 patients got severe disability, and 4 patients died. Conclusion The clinical feature of traumatic hematoma of the posterior fossa is different from supratentorial hematoma. Commonly, the patients have mild disturbance of conscious,and the nystagnms and ataxia are uncommon, but the unspecialized signs such as headache, vomiting, uneasy are very common, and foraman magnum hernia lakes place easily. So intensive observation of the symptoms CT scan and the timely operation can decrease the morbidity and mortality of patients.