Shirasaka A, Shinohara Y, Kuwahara T, Sumiya K, Ninchoji T, Uemura K
Department of Neurosurgery, Shida General Hospital of Fujieda, Japan.
No Shinkei Geka. 1992 Sep;20(9):955-8.
Computed tomography(CT) scan has revealed that certain acute epidural hematomas(AEH) don't need operative therapies. But, it is difficult to determine especially in childhood, whether AEH compressing the brain for a short-term would or would not effect the function of the central nervous system in the future. For this reason, the authors report the long-term prognosis of nonoperative AEH in children. Twelve children suffering from AEH were transported to our clinic. On admission, they had no neurological deficits and CT scan revealed hematomas that had maximum thickness of 5-19 mm without midline shift. With nonoperative therapy they were discharged and the hematomas disappeared within 3-12 weeks. After long-term follow-up (3-10 years), it was shown that they had no epileptic episodes, and no changes in their school study records. Also, the Yatabe-Guilford personality test revealed no abnormal data. These data suggest that children can be cured who suffer from AEH with no neural deficits, and in whom the maximum thickness of the AEH is less than 20 mm, and in whom there is no midline shift in CT scan, can be cured without undergoing an operation, and will have a good long-term prognosis.
计算机断层扫描(CT)显示,某些急性硬膜外血肿(AEH)无需手术治疗。但是,尤其是在儿童中,很难确定短期压迫大脑的AEH是否会在未来影响中枢神经系统的功能。因此,作者报告了儿童非手术治疗AEH的长期预后。12名患有AEH的儿童被送往我们的诊所。入院时,他们没有神经功能缺损,CT扫描显示血肿最大厚度为5-19毫米,无中线移位。经过非手术治疗,他们出院了,血肿在3-12周内消失。经过长期随访(3-10年),结果显示他们没有癫痫发作,学校学习记录也没有变化。此外,矢田部-吉尔福德人格测试未显示异常数据。这些数据表明,对于没有神经功能缺损、AEH最大厚度小于20毫米且CT扫描无中线移位的AEH患儿,无需手术即可治愈,且长期预后良好。