Rochat P, Johannesen H H, Poulsgård L, Bøgeskov L
Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
Clin Neurol Neurosurg. 2002 Dec;105(1):39-41. doi: 10.1016/s0303-8467(02)00099-9.
Sequentially evolved bilateral epidural haematomas, where the second haematoma evolves after surgical removal of the first haematoma, are rarely reported. We report two cases of this entity. One patient was involved in a road traffic accident and the other was suffering from a head injury after an assault. CT scans showed that both patients had an unilateral epidural haematoma with a thin presumably epidural haemorrhage on the opposite side. Both patients were operated for their epidural haematomas, but did not improve after surgical treatment, and postoperative CT scans revealed evolving of an epidural haematoma on the opposite side. After evacuation of the second epidural haematoma both patients recovered quickly. Sequentially evolved bilateral epidural haematomas are rare, but must be considered in the postoperative intensive care treatment in patients with epidural haematomas. Both cases emphasize the need for intensive care monitoring after an operation for an epidural haematoma and the need for CT scans if the patient does not improve quickly after removal of the haematoma. This is especially important if a small contralateral haematoma is seen on the initial CT scan.
序贯性发生的双侧硬膜外血肿，即第二个血肿在第一个血肿手术清除后出现，鲜有报道。我们报告两例此病例。一例患者遭遇道路交通事故，另一例在遭袭击后头部受伤。CT扫描显示，两名患者均有单侧硬膜外血肿，对侧有少量疑似硬膜外出血。两名患者均接受了硬膜外血肿手术，但术后病情未改善，术后CT扫描显示对侧硬膜外血肿在进展。清除第二个硬膜外血肿后，两名患者均迅速康复。序贯性发生的双侧硬膜外血肿罕见，但在硬膜外血肿患者的术后重症监护治疗中必须予以考虑。这两例均强调了硬膜外血肿手术后重症监护监测的必要性，以及血肿清除后患者若未迅速改善则需进行CT扫描的必要性。如果在初始CT扫描中发现对侧有小血肿，这一点尤为重要。
