Motohashi O, Tominaga T, Shimizu H, Koshu K, Yoshimoto T
Department of Neurosurgery, Kohnan Hospital, Japan.
No To Shinkei. 2000 Sep;52(9):833-6.
We report a rare case of the acute epidural hematoma caused by contrecoup injury. A 59-year-old woman came to our hospital on foot because of her head injury. She slipped on a stone and hit her occiput against the concrete floor without loss of consciousness. On admission she was alert and complained of dizziness and nausea without neurological deficits. She had a subcutaneous hematoma in the occiput. There was no Battle's sign nor cerebrospinal fluid leakage. Skull film revealed a linear fracture of the occipital bone. Computed Tomography(CT) of the brain showed the acute epidural hematoma at the left frontal region. She was treated conservatively and discharged 19 days after injury without neurological deficits. The mechanism of this lesion is speculated as follows: the deformation of the skull and the negative pressure produced in the frontal region with the occipital injury stripped the dura mater from the calvarium, which lead to the rupture and hemorrhage of the small interposed vessels resulting in the epidural hematoma.
我们报告一例因对冲伤导致的罕见急性硬膜外血肿病例。一名59岁女性因头部受伤步行前来我院。她在石头上滑倒，枕部撞到水泥地面，当时未失去意识。入院时她神志清醒，主诉头晕、恶心，无神经功能缺损。枕部有皮下血肿。没有Battle征，也没有脑脊液漏。颅骨X线片显示枕骨线性骨折。脑部计算机断层扫描（CT）显示左额叶急性硬膜外血肿。她接受了保守治疗，伤后19天出院，无神经功能缺损。推测该病变的机制如下：枕部受伤时颅骨变形以及额部产生的负压使硬脑膜从颅骨剥离，导致其间小血管破裂出血，从而形成硬膜外血肿。
