创伤性后颅窝血肿

Traumatic hematoma on the posterior fossa

目的 总结创伤性后颅窝血肿 (THPF)的临床特点。方法 对我科 1999年 3月～ 2 0 0 1年 10月间收治并接受手术治疗的 9例THPF的病例资料进行回顾性分析。结果 (1) 9例均有枕部着力的致伤机制 ,其中跌倒和低高度坠落伤 7例 ;硬膜外血肿 8例 ,小脑挫裂伤伴小脑血肿 1例 ;(2 )就诊时GCS 13～ 15分 6例 ,7例头部外伤后有短暂的昏迷史或创伤后遗忘 ,4例有头痛或呕吐主诉 ;(3) 8例接受硬膜外血肿清除后颅减压术 ,1例行小脑血肿清除后颅减压加侧脑室外引流术 ;其中 7例恢复良好 ,1例中残 ,1例死亡。结论 THPF有着不同于幕上创伤性颅内血肿的临床特点 。

Objective To study the clinical features of patients with head injury who suffered from traumatic hematoma on the posterior fossa(THPF).?Methods Nine patients hospitalized in our department from March 1999 to October 2001 with THPF which needed to be operated on were analyzed.?Results (1)?All of our patients had a direct injury to the occipital region. The etiology was a fall in seven patients. Eight cases suffered from epidural hematoma, one had intracerebellar hematoma and contusion.?(2)?Six patients admitted with a Glasgow Coma Scale score over 12.?Seven patients had a transient loss of consciousness after injury or posttraumatic amnesia on admission. Four patients admitted with symptoms as headache or vomiting.?(3)?Eight patients underwent evacuation of epidural hematoma and decompression of the posterior fossa. One patient underwent evacuation of intracerebellar hematoma with decompression of the posterior fossa and external ventricular drainage. Among these, seven cases had a good recovery,one moderately disabled and one died.?Conclusion The clinical features of patients suffereding THPF differ from those patients suffered from supratentorial traumatic intracranial hematoma. Early diagnosis and immediate treatment are essential for improving the prognosis of patients affected by THPF.