Kinoshita Yoshimasa, Yasukouchi Hideoki, Tsuru Eichi, Okudera Toshio, Yokota Akira
Department of Neurosurgery, Munakata Suikokai General Hospital.
No Shinkei Geka. 2004 Nov;32(11):1139-43.
A 16-year-old man who presented with delayed bleeding of epidural hematoma is reported. Computed tomography (CT) on admission demonstrated a small amount of right epidural hematoma and a small fracture of the right lateral orbital wall. He was treated conservatively. Repeated CT scans and magnetic resonance (MR) imaging revealed no growth in the epidural hematoma, but demonstrated flow void sign at the medial side of the hematoma on MR images. After 8 days, CT scan presented the regrowth of the hematoma, so we planned the removal of hematoma. Epidural hematoma due to the rupture of a traumatic pseudoaneurysm of the middle meningeal artery is rare. Especially, since traumatic lesions were diagnosed by CT, it was unusual to be able to diagnose the pseudoaneurysm of middle meningeal artery preoperatively. The cases of epidural hematoma treated conservatively should be followed up by MR imaging and MR angiography using the fat suppression technique.
本文报道了一名16岁男性患者,其表现为硬膜外血肿延迟出血。入院时的计算机断层扫描(CT)显示右侧少量硬膜外血肿及右侧眶外侧壁小骨折。对其进行了保守治疗。重复CT扫描及磁共振(MR)成像显示硬膜外血肿无增大,但MR图像上血肿内侧出现流空信号。8天后,CT扫描显示血肿再次增大,因此我们计划进行血肿清除术。因脑膜中动脉外伤性假性动脉瘤破裂导致的硬膜外血肿较为罕见。特别是,由于外伤病变通过CT诊断,术前能够诊断脑膜中动脉假性动脉瘤实属罕见。对于保守治疗的硬膜外血肿病例,应采用脂肪抑制技术进行MR成像及MR血管造影随访。