Kumar Jayendra, Harsh Viraat, Strickland Ben A, Sahay Chandra B, Kumar Anil
Department of Neurosurgery, Narayan Medical College and Hospital, Sasaram, Bihar, India.
Department of Neurosurgery, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
World Neurosurg. 2016 Apr;88:694.e1-694.e4. doi: 10.1016/j.wneu.2015.12.062. Epub 2015 Dec 24.
Posttraumatic posterior fossa epidural hygroma is a rare entity, and a clear management has not been established in the medical literature. We present 1 case and review the literature relevant to this unusual entity. The mechanism of formation and management of posterior cranial fossa epidural hygroma are also outlined.
A 2-year-old child presented after a rooftop fall injury with symptoms of headache, drowsiness, vomiting, and brief loss of consciousness. Computed tomography scan demonstrated swelling in the left occipital region and epidural hygroma. After conservative management failed, surgical repair of the dura mater was performed. The child was discharged postoperative day 11 in stable condition with marked improvement in occipital swelling.
It is imperative to consider epidural hygroma in very small children presenting with occipital injury. As a result of loose adhesion of dura mater and internal cranial lamina layers in younger pediatric patients, potential epidural space may be easily created secondary to injury, and small breaches in meningeal integrity near the cisterna magna may favor cerebrospinal fluid leak. During surgery, if watertight repair of a visible dural tear is performed, duro-periosteal hitching or vacuum drain placement may not be required.
创伤后颅后窝硬膜外积液是一种罕见的病症，医学文献中尚未确立明确的治疗方法。我们报告1例病例并回顾与这种不寻常病症相关的文献。同时概述颅后窝硬膜外积液的形成机制和治疗方法。
一名2岁儿童因从屋顶坠落受伤后出现头痛、嗜睡、呕吐和短暂意识丧失等症状。计算机断层扫描显示左枕部肿胀及硬膜外积液。保守治疗失败后，进行了硬脑膜手术修复。患儿术后第11天出院，情况稳定，枕部肿胀明显改善。
对于有枕部损伤的幼儿，必须考虑硬膜外积液。由于小儿患者硬脑膜与颅内板层粘连疏松，受伤后可能容易形成潜在的硬膜外间隙，枕大池附近脑膜完整性的小破损可能有利于脑脊液漏出。手术过程中，如果对可见的硬脑膜撕裂进行了严密修复，可能不需要进行硬脑膜-骨膜缝合或放置引流管。
