迟发性外伤性硬膜外血肿

DELAYED TRAUMATIC EXTRADURAL HEMATOMAS

作者报告经CT或手术证实的迟发性硬膜外血肿5例,占同期硬膜外血肿的6.0％。其主要临床特点是:(1)颅脑损伤比较严重;(2)兼有冲击性和对冲性损伤;(3)多数在颅内血肿清除术和去骨瓣减压术后发生;(4)常见部位在着力点附近。严密观察病情和及时进行CT复查是诊断本病的最佳方法。当病情危急或没有CT时,应钻孔探查着力点附近。本文对引起本病的主要原因也进行了简要讨论。

Delayed extradural hematomas (DEDH) were found in 5 cases,with an incidence of 6.0% in the patients with extradural hematoma during the same period.Its main clinical features include:(1) relatively severe head injury;(2)presence of both impaction and contrecoup injury;(3) occurring after a hematoma evacuation or a decompressve craniotomy;and (4)usually developing in the impacted part of the head.The most important points to detect this condition are close observation of the patient and repeat GT scan in time.If the patient's condition is critical and CT scan is not available,a trephine exploration should be made near the point of impaction injury.The main causes of this condition are discussed in brief.