外伤性骑跨横窦硬脑膜外血肿46例临床分析

Clinical analysis of 46 patients with traumatic epidural hematomas straddling transverse sinuses

目的探讨外伤性骑跨横窦硬脑膜外血肿的形成机制、诊断、临床治疗方法及疗效。方法回顾性分析2006年1月—2012年1月收治的46例外伤性骑跨横窦硬脑膜外血肿患者的临床资料。结果本组46例病人中35例手术治疗,11例非手术治疗。恢复良好38例,中或重度残疾6例,死亡2例。结论骑跨横窦硬脑膜外血肿缺乏典型的临床表现,且病情常急剧恶化,早作头颅CT扫描、早诊断、早治疗,有手术指征者尽早手术,术中充分减压、止血、避免横窦二次受压和注意对冲性损伤,是提高外伤性骑跨横窦硬脑膜外血肿疗效的关键。

Objective To discuss the formation mechanism,diagnosis,clinical treatment and curative effect of traumatic epidural hematomas straddling transverse sinuses. Methods The clinical data of 46 patients with traumatic epidural hematomas straddling transverse sinuses,who were treated in our department from January 2006 to January 2012,were analyzed retrospectively. Results Of 46 patients,35 were treated by the surgery and 11 by the conservative methods.Of 46 patients,38 were recovered well,6 moderately or severely disabilled and 2 patients died. Conclusion There were no distinctive clinical manifestations and the acute clinical deterioration is common in the patients with traumatic epidural hematomas straddling transverse sinuses.Head CT scan as early as possible,early diagnosis and surgery,full decompression in surgery,hemostasis,avoiding the transverse sinuses from secondary compression and the hedge brain injury are key points for improve the efficacy of traumatic epidural hematomas straddling transverse sinuses.