急性颅内血肿清除后继发对侧迟发性血肿

Occurrence of contralateral delayed hematoma after acute intracranial hematoma evacuation

目的：急性外伤性颅内血肿清除的术中及术后，如及时发现对侧迟发性血肿并治疗可提高疗效。方法：在术中发生急性脑肿胀时应在对侧钻颅探查或术后病人恶化时行ＣＴ检查。结果：治疗３０例对侧迟发血肿病人其中１０例死亡，手术死亡率为３３．３％。结论：在清除急性外伤性颅内血肿时发生急性脑肿胀或术后病情恶化应想到对侧可能是迟发性血肿形成，宜尽早钻颅探查或复查ＣＴ，早诊早治可改善预后。

Objective: To increase the operative effectiveness by on time diagnosis and management of intra and postoperative delayed intracranial hematoma. Methods: Contralateral Burr hole were done and CT scan was performed in postoperative deteriorating patients. Result: 30 patients of contralateral delayed hematoma were evacuated with 10 patients died. The operative mortality was 33%. Conclusion: On time Burr hole and repeat CT scan will improve the prognosis of acute operative brain swelling and postoperative deteriorating patients.