CT诊断外伤性小脑幕及大脑镰硬膜下血肿的应用价值

Value of CT on diagnosis of traumatic subdural hematoma in tentorial and falx

目的探讨CT诊断小脑幕及大脑镰硬膜下血肿的应用价值。方法回顾性分析35例具有完整资料的外伤性小脑幕及大脑镰硬膜下血肿的CT表现特点。结果本组35例,其中大脑镰硬膜下血肿20例;小脑幕硬膜下血肿10例;小脑幕并大脑镰硬膜下血肿5例;首次正确诊断30例,3例误诊为蛛网膜下腔出血,2例误诊为大脑镰钙化;大脑镰硬膜下血肿表现为细绳索状3例,呈粗绳索状17例;小脑幕硬膜下血肿4例呈片状,2例呈新月形,4例呈扇形;小脑幕并大脑镰硬膜下血肿3例呈镰刀形,2例呈＂Y＂形。24 h至2个月复查CT：蛛网膜下腔出血7 d内完全吸收;大脑镰钙化图像无变化;硬膜下少量血肿20例（57.1%）14~20 d基本吸收,硬膜下血肿较大者15例（42.8%）4周至2个月变为低密度。结论小脑幕和大脑镰硬膜下血肿的CT表现具有特征性,CT检查不仅可早期明确诊断,亦可及时发现是否存在颅脑其他损伤,动态观察对其诊断和鉴别诊断具有较大帮助。

Objective To evaluate the value of CT on diagnosis of traumatic subdural hematoma in tentorial and falx.Methods A retrospective analysis the performance characteristics of CT on 35 cases with complete information on traumatic tentorial and falx subdural hematoma.Results The group of 35 cases,of which the falx subdural hematoma in 20 cases;tentorial subdural hematoma in 10 cases;tentorium and falx subdural hematoma in 5 cases;for the first time the correct diagnosis of 30 cases,3 cases were misdiagnosed as subarachnoid hemorrhage;2 cases misdiagnosed as cerebral falx calcification;falx subdural hematoma manifested as thin rope-like in 3 cases,showed thick rope-like in 17 cases;in tentorial subdural hematoma 4 cases showed sheets,2 cases were crescent-shaped,4 cases of fan-shaped;in tentorium and falx subdural hematoma 3 cases showed sickle-shaped,2cases were ＂Y＂ shape.24 h-2 Yue Review CT：subarachnoid hemorrhage within 7 days completely absorbed;falx calcification of the image unchanged;a small subdural hematoma in 20 cases（57.1%） almost absorbed in 14 ~ 20 days,large subdural hematoma in 15 cases（42.8%） turn into a low density in 4 weeks to 2 months.Conclusion The tentorium and falx subdural hematoma with characteristic in CT manifestations,CT examination can not only early diagnosis,but also discover the existence of other brain injury,dynamic observation is more helpful for its diagnosis and differential diagnosis.