Bhat Abdul Rashid, Raswan Uday Singh, Kirmani Altaf Rehman
Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
J Pediatr Neurosci. 2015 Jul-Sep;10(3):266-9. doi: 10.4103/1817-1745.165698.
The surgical option to evacuate an intracranial extradural hematoma (EDH) was postponed in a 2-year-old female child who appeared fully alert and active after a brief spell of unconsciousness following a fall from height. The child was received, with a swelling on and around the right parietal eminence, by the emergency staff just half an hour after the time of injury. The immediate X-ray skull and first computed tomography (CT) scan head showed a parietal bone fracture, EDH, and cephalhematoma. However, follow-up CT scan head after about 4½ h revealed the dramatic absence of EDH but increased size and bogginess of cephalhematoma. The EDH had transported into subgaleal space resulting in a decompression of intracranial compartment in <5 h, thereby preventing surgical intervention but necessitating monitoring, though there was no back flow intracranially.
一名2岁女童从高处坠落，短暂昏迷后看似完全清醒且活跃，因此推迟了清除颅内硬膜外血肿（EDH）的手术。受伤半小时后，急救人员接诊了该女童，其右顶骨隆突及其周围有肿胀。颅骨X线平片和首次头颅计算机断层扫描（CT）显示顶骨骨折、硬膜外血肿和头皮血肿。然而，约4个半小时后的头颅CT复查显示硬膜外血肿显著消失，但头皮血肿增大且有波动感。硬膜外血肿已转移至帽状腱膜下间隙，在不到5小时内使颅内腔室减压，从而避免了手术干预，但仍需进行监测，尽管没有颅内血液回流情况。
