Sato Shinsuke, Mitsuyama Tetsuryu, Ishii Akira, Kawamata Takakazu
Department of Neurosurgery, Tokyo Women's Medical University Yachiyo Medical Center, 477-96 Owada-Shinden, Yachiyo-shi, Chiba 276-8524, Japan.
J Clin Neurosci. 2009 Jun;16(6):834-7. doi: 10.1016/j.jocn.2008.08.023. Epub 2009 Mar 18.
We encountered a case of head trauma with very unusual delayed events. A 68-year-old woman was admitted to our hospital after receiving a direct impact to her occiput in a traffic accident. Head CT scans showed a thin acute epidural hematoma in the posterior fossa corresponding to a linear fracture, followed by late onset of contrecoup left frontal epidural hematoma and subsequent cerebellar contusion in the right cerebellar hemisphere. Fifteen days after the trauma, the patient developed mild motor weakness of right upper extremity. MRIs demonstrated an infarct in the territory of the left recurrent artery of Heubner. Although rare, atypical late events in patients with head trauma as reported here should be taken into consideration during subacute follow-up periods.
我们遇到了一例头部外伤且伴有非常不寻常的延迟事件的病例。一名68岁女性在交通事故中枕部受到直接撞击后被送入我院。头部CT扫描显示后颅窝有一个与线性骨折相对应的薄的急性硬膜外血肿,随后出现迟发性对冲性左额叶硬膜外血肿,以及随后右侧小脑半球的小脑挫伤。外伤后15天,患者出现右上肢轻度运动无力。MRI显示Heubner回返动脉供血区梗死。尽管罕见,但在亚急性随访期间应考虑到此处报道的头部外伤患者的非典型延迟事件。