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Neurology：消失的硬膜外血肿

2021-12-28 brainnew神内神外 网络

急性硬膜外血肿
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作者认为，虽然罕见，但由于凝血障碍患者颅内压迅速升高，急性硬膜外血肿可完全转变为帽状腱膜下血肿。

 

来源:脑血管病及重症文献导读
54岁，男性。
头部外伤后2小时出现昏迷。
（A，B）外伤后1小时CT显示右侧颞部硬膜外血肿、蛛网膜下腔出血（箭头）和左侧额部薄层硬膜下血肿（箭头）。（C）1小时后复查CT显示左侧硬膜下血肿扩大（箭头），右侧硬膜外血肿消失，并新发右侧帽状腱膜下血肿（E，F；箭头），中线向右移位（D，E）。消失的硬膜外血肿可能通过骨折线（G，H；箭头）转移到帽状腱膜下血肿：
制定手术方案，先清除左侧硬膜下血肿，再清除右侧帽状腱膜下血肿。然而，呼吸和心脏骤停，并伴有持续低血压，血液检查发现急性凝血障碍和血小板减少，这是手术禁忌。保守治疗，伤后36小时死亡。

作者认为，虽然罕见，但由于凝血障碍患者颅内压迅速升高，急性硬膜外血肿可完全转变为帽状腱膜下血肿。

 

文献出处：
Neurology. 2021 Nov 30;97(22):1031-1032. doi: 10.1212/WNL.0000000000012888. Epub 2021 Oct 4.
Rapid Disappearance of Acute Unilateral Epidural Hematoma Due to Compression of Contralateral Subdural Hematoma

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    2022-07-20 zhs3892

    #硬膜外血肿#

    0

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    2022-12-02 12498ebem19暂无昵称

    #硬膜外#

    0

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    2022-11-30 yinhl1978

    #Neurol#

    0

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    2021-12-29 654699882_84926986

    #血肿#

    0

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    2021-12-28 云舒

    🉑️

    0

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    2021-12-28 ms1000001656413688

    学习

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