Joki T, Hashimoto T, Akachi K, Boku M, Suzuki K, Nakamura N
Department of Neurosurgery, Jikei University School of Medicine.
No Shinkei Geka. 1992 Aug;20(8):915-9.
We reported two cases of rapid resolution of acute subdural hematoma. Case 1, a 21-year-old female, sustained head trauma and became unconscious for about 15 min. Probably she was suffering from posttraumatic amnesia for about 1 day. On admission J.C.S and G.C.S were 20 and 9 (2 + 2 + 5) points, respectively. Neurological examination showed no abnormalities. An initial computed tomography (CT) scan taken 2 hours after the injury showed a high dense subdural hematoma on the left cerebral hemisphere and hemispheric swelling. She was conservatively treated. A follow up CT scan taken 8 hours after the injury disclosed rapid disappearance of the hematoma and cerebral swelling. Case 2a 23-year-old male, sustained head trauma and became unconscious for about 30 min. On admission J.C.S and G.C.S were 1 and 14 (4 + 4 + 6) points, respectively, and slight right hemiparesis was noted. An initial CT scan taken 2 hours after the injury showed subdural hematoma of the left cerebral hemisphere and hemispheric swelling. He was conservatively treated. A follow up CT scan taken 24 hours after the injury revealed almost complete disappearance of the subdural hematoma and cerebral swelling. It was suggested that the rapid resolution of acute subdural hematoma was attributable to redistribution due to decrease of ICP, and washing out by cerebrospinal fluid.
我们报告了两例急性硬膜下血肿迅速消退的病例。病例1,一名21岁女性,头部受伤后昏迷约15分钟。她可能患有创伤后遗忘症约1天。入院时,日本昏迷量表(J.C.S)和格拉斯哥昏迷量表(G.C.S)分别为20分和9分(2 + 2 + 5)。神经系统检查未发现异常。受伤后2小时进行的首次计算机断层扫描(CT)显示左脑半球有高密度硬膜下血肿和半球肿胀。她接受了保守治疗。受伤后8小时进行的后续CT扫描显示血肿和脑肿胀迅速消失。病例2,一名23岁男性,头部受伤后昏迷约30分钟。入院时,J.C.S和G.C.S分别为1分和14分(4 + 4 + 6),并注意到有轻微的右侧偏瘫。受伤后2小时进行的首次CT扫描显示左脑半球硬膜下血肿和半球肿胀。他接受了保守治疗。受伤后24小时进行的后续CT扫描显示硬膜下血肿和脑肿胀几乎完全消失。提示急性硬膜下血肿的迅速消退归因于颅内压降低导致的再分布以及脑脊液的冲洗作用。