额叶挫伤合并隐匿性跨上矢状窦硬膜外血肿的诊断与治疗

Diagnosis and treatment of hidden extradural hematoma straddle superior sagittal sinus combined with frontal lobe contusion

目的探讨额叶挫伤合并隐匿性跨上矢状窦硬膜外血肿的诊断与治疗原则。方法回顾性分析山东省千佛山医院神经外四科自2012年11月至2017年11月收治的额叶挫伤合并跨上矢状窦硬膜外血肿患者12例,术前行颅脑冠状位及矢状位CT及三维重建,根据影像学所示颅内出血损伤程度制定相应治疗方案,观察临床疗效。结果 12例患者术后恢复GOSⅤ级6例(包括4例保守治疗),GOSⅣ级3例,GOSⅢ级2例,GOSⅡ级1例。结论早期准确诊断额叶挫伤合并跨上矢状窦硬膜外血肿并选择合理的处理方式对患者的预后有重要意义。

Objective To investigate the principle of the diagnosis and treatment of hidden extradural hematoma straddle superior sagittal sinus combined with frontal lobe contusion. Methods From November 2012 to November 2017, 12 cases of hidden extradural hematoma straddle superior sagittal sinus combined with Frontal Lobe Contusion admitted to Department of Neurosurgery, Shandong Provincial Qianfoshan Hospital were retrospectively analyzed, Preoperative brain coronal and sagittal CT and 3 D reconstruction were performed, and the corresponding treatment plan was established according to the degree of intracranial hemorrhage and injury and the clinical efficacy was observed. Results In12 patients, 6 cases of GOS Ⅴ were recovered after operation, including 4 patients with conservative treatment, 3 cases of GOSⅣ, 2 cases of GOSⅢ, 1 case of GOSⅡ level. Conclusion It is important for the prognosis of patients to accurately diagnose extradural hematoma straddle superior sagittal sinus combined with frontal lobe contusion and to choose a reasonable treatment.