远隔性小脑出血CT表现

The CT manifestations and diagnosis of remote cerebellar hemorrhage

目的:探讨幕上开颅术后远隔性小脑出血(RCH)的临床及影像表现。方法:3例脑膜瘤患者行开颅手术后出现意识障碍,行紧急CT平扫发现并发RCH,回顾性分析RCH的临床及影像学表现。结果:2例术后手术部位可见大量硬膜下血肿及少量蛛网膜下腔岀血,此2例可见两侧小脑上表面脑沟、脑叶岀血,呈"斑马征";1例手术后可见少量左侧小脑上表面叶及右侧天幕缘出血。结论:典型RCH表现为小脑单侧或双侧表面沟或小脑叶裂弧条线高密度影,呈"斑马征",为其特征性CT表现,与术后颅内压突然增高或降低,引起脑组织移位,导致桥静脉断裂有关。

Objective：To investigate the clinical and imaging manifestations of remote cerebellar hemorrhage （RCH） after supratentorial craniotomies. Methods： Three patients of meningioma had unconsciousness occurred after supratentorial craniotomy,RCH was found on CT without contrast enhancement during emergency. The clinical and imaging manifesta- tions of RCH were retrospectively analyzed. Results：Massive subdural hematoma and a small amount of sub arachnoid hem- orrhage located at the operation region were found in two patients, with bilateral superficial cerebellar sulci and lobar hemor rhage,showing as ＂Zebra Sign＂. The third patient presented with small amount of hemorrhage in the left superior sulci and right infra tentorial region. Conclusion：The typical CT manifestations of RCH appears as high density in unilateral or bilat- eral superficial sulci or cerebellar fissures,which is referred as ＂Zebra Sign＂. It is believed that RCH is related to sudden in- crease or decrease of intracranial pressure, displacement of brain tissue, which leads to laceration of superior cerebellar bridging vein and its tributaries.