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颅骨切除术后急性对侧硬脑膜下积液

Acute contralateral subdural hygroma following craniectomy.

作者信息

Su Feng-Wen, Ho Jih-Tsun, Wang Hung-Chen

机构信息

Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

出版信息

J Clin Neurosci. 2008 Mar;15(3):305-7. doi: 10.1016/j.jocn.2006.08.019. Epub 2008 Jan 7.

Abstract

We report a case of acute contralateral subdural hygroma (SDG) following decompressive craniectomy and discuss the potential aetiologies of the SDG. A 63-year-old man experienced drowsiness (Glasgow coma scale score 13) after a fall that resulted in head trauma. Brain CT revealed a subdural haematoma at the right fronto-temporo-parietal region with a midline shift to the left. Craniectomy for evacuation of the subdural haematoma was performed immediately. A delayed intracerebral haematoma with mass effect in the right frontotemporal region developed later, and was removed in a second operation. Although the patient's neurological status improved postoperatively, gradual deterioration was observed during the follow-up period. Contralateral SDG with a midline shift to the right was noted in a follow-up brain CT scan. The patient's condition improved after drainage of the SDG and he was discharged 1 week later.

摘要

我们报告1例减压性颅骨切除术后急性对侧硬脑膜下积液(SDG)的病例,并探讨SDG的潜在病因。一名63岁男性在跌倒导致头部外伤后出现嗜睡(格拉斯哥昏迷量表评分为13分)。脑部CT显示右侧额颞顶区硬膜下血肿,中线向左移位。立即进行颅骨切除术以清除硬膜下血肿。随后在右侧额颞区出现具有占位效应的迟发性脑内血肿,并在第二次手术中予以清除。尽管患者术后神经状态有所改善,但在随访期间观察到病情逐渐恶化。随访脑部CT扫描发现对侧SDG,中线向右移位。SDG引流后患者病情改善,1周后出院。

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