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小儿创伤性斜坡后硬膜外血肿——病例报告及文献复习

Traumatic retroclival epidural hematoma in pediatric patient-Case report and review of literature.

作者信息

Tahir Muhammad Zubair, Quadri S A, Hanif Sonia, Javed Gohar

机构信息

Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan.

出版信息

Surg Neurol Int. 2011;2:78. doi: 10.4103/2152-7806.82085. Epub 2011 Jun 15.

Abstract

BACKGROUND

Retroclival epidural hematoma (REDH) is a very rare entity in the practical field of neurosurgery. Only a few cases have been reported in literature. The authors present to you case of a 12-year-old female, a victim of road traffic accident (RTA), who had presented to us with loss of consciousness and seizures.

CASE DESCRIPTION

Magnetic resonance imaging revealed retroclival hematoma. She was managed on conservative grounds and discharged with assurance of multiple follow-up visits.

CONCLUSION

Very few cases of REDH have been reported in pediatric population to date. It should be suspected in children with head and neck injuries who have been a victim of RTAs. Most likely underdiagnosed due to its rarity; therefore, MRI should be considered when the suspicion is high. Atlanto-occipital dislocation should always be kept under consideration in all cases, and therefore should be managed and monitored very cautiously. In this report, the authors also present concise review of the literature pertaining to the pathogenesis and management of this rare clinical entity which has a high likelihood to be encountered and underdiagnosed by neurosurgeons in Emergency Room.

摘要

背景

斜坡后硬膜外血肿(REDH)在神经外科实际领域中是一种非常罕见的病症。文献中仅报道了少数病例。作者向您介绍一名12岁女性的病例,她是道路交通事故(RTA)的受害者,因意识丧失和癫痫发作前来就诊。

病例描述

磁共振成像显示斜坡后血肿。她接受了保守治疗,并在保证多次随访的情况下出院。

结论

迄今为止,儿科人群中报道的REDH病例非常少。对于头部和颈部受伤且是RTA受害者的儿童应怀疑此病。由于其罕见性,很可能诊断不足;因此,当怀疑度高时应考虑进行磁共振成像检查。在所有病例中都应始终考虑寰枕脱位,因此应对其进行非常谨慎的处理和监测。在本报告中,作者还对与这种罕见临床病症的发病机制和治疗相关的文献进行了简要综述,神经外科医生在急诊室很可能会遇到并漏诊这种病症。

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