颅内表皮样囊肿术后迟发性颅内出血（附15例报告）

A rare post - operative complication in epidermoid cyst cases： delayed intracranial hemorrhage （report of 15cases）

目的介绍颅内表皮样囊肿手术后一种罕见并发症——自发性颅内出血，总结分析其临床特点，提高对该并发症的认识，改善患者预后。方法回顾1985年1月至2008年12月诊治的所有表皮样囊肿患者的临床资料，分析该并发症的病例特点及高危因素。结果颅内表皮样囊肿患者共737例，其中手术治疗719例，术后出现自发性颅内出血15例（2．1％），男5例，女10例，（男／女=1：2），平均年龄（39±8）岁，出血发生在术后第（9±3．7）天，死亡10例（66．7％）。结论颅内表皮样囊肿术后第5—18天为发生致命性颅内出血的高危期，目前尚无规律可循，因此应提高对这种罕见并发症的警惕，争取早发现，早抢救，改善患者预后。

Objective To introduce a rare post - operative complication, delayed intracranial hemorrhage in epidermoid cyst cases, to summarize its clinical features and improve the prognosis. Methods Allepiclermoid cyst cases treated in our department from Jan. 1985 to Dee. 2008 were retrospectively reviewed. The clinical features and high risk factors were analyzed in the cases suffered from delayed intracranial hemorrhage. Results In all 737 epidermoid cyst cases, 719 cases underwent operation, delayed intracranial hemorrhage occurred in 15 cases （2.0%） , 5 Male and 10 female cases, the mean age was 39 ± 8 yrs, the hemorrhage occurred during 9 ±3.7 days postoperatively, 10 of the 15 cases dead. Conclusion In intracranial cpidermoid cyst cases, the postoperative period between 5^th to 18^th clays is the high risk time - window for delayed intracranial hemorrhage, there was no statistically significant risk factor available at present, so neurosurgeon should be cautious with this rare complication.