骨瓣成形术清除迟发性骑跨横窦巨大硬膜外血肿

Eavcution of tardive enormous epidural hematoma stradding transverse sinus by cranioplasty

目的：探讨骨瓣成形术清除迟发性骑跨横窦巨大硬膜外血肿的临床效果。方法对11例迟发性骑跨横窦巨大硬膜外血肿，采用枕部倒“U”切口骨瓣成形清除血肿的手术方法。结果术前幕上血肿约40～120 ml，幕下血肿约10～15 ml左右。骑跨横窦巨大硬膜外血肿均被清除彻底，且止血可靠，骨瓣复位稳定。结论与传统手术方式相比，骨瓣成形术清除骑跨横窦的硬膜外血肿具有进颅迅速、直视止血、不留颅骨缺损等优点。

Objective To explore the clinical effect of tardive enormous epidural hemaomas stradding transverse sinus with cranioplasty .Methods The clinical data of 11 patients with tardive epidural hematoma stradding transverse sinus,who were treated in our department were analyzed retrospectively .Cleaning up the hematomas by transoccipital craniotomy through reverse U incision was performed .Results The volume of supratentorial hematoma was 40--120 ml,and of infratentorial hemotoma was 10--15 ml before opration .A postoperative CT scan demonstrated complete resolution of the epidural hematoma ,safety hemostasis,stable replacement of bone flap .Conclusions The tardive epidural hematomas stradding transverse sinus can be rapidly and smoothly evacuated by cranioplasty ,which is easier and no cranial bone defect ane stop bleeding more completely in comparison with traditional oprative method .