Kroon Elke, Bok Levinus A, Halbertsma Feico
Pediatrics Department, Maxima Medisch Centrum Veldhoven, Veldhoven, Netherlands.
BMJ Case Rep. 2012 Feb 21;2012:bcr0920114735. doi: 10.1136/bcr.09.2011.4735.
A full-term neonate, born by caesarean section, presents with focal seizures. EEG and cranial ultrasound are normal. MRI of the cerebrum shows an epidural haematoma. Perinatal intracranial haemorrhage in the full-term newborn is an important cause of morbidity and mortality. Most perinatal intracranial haemorrhages are located either subdural or intracerebral, rarely epidural. Epidural haemorrhage is usually a complication of assisted delivery, however it may also occur without forcipal or vacuum extraction, as demonstrated in this case. An epidural haemorrhage should be suspected on clinical findings, even in the absence of an assisted delivery. As cranial ultrasound sonography often misses epidural haemorrhage due to parietal location of the haemorrhage, the diagnosis needs either cerebral CT or MRI.
一名足月新生儿，通过剖宫产出生，出现局灶性癫痫发作。脑电图和头颅超声检查正常。大脑磁共振成像显示硬膜外血肿。足月新生儿围产期颅内出血是发病和死亡的重要原因。大多数围产期颅内出血位于硬膜下或脑内，硬膜外出血很少见。硬膜外出血通常是助产的并发症，然而，如本病例所示，即使没有产钳或真空吸引也可能发生。即使没有助产史，根据临床表现也应怀疑硬膜外出血。由于出血位于顶叶，头颅超声检查常漏诊硬膜外出血，因此诊断需要进行脑部CT或磁共振成像检查。
