Gartman J J, Atstupenas E A, Vollmer D G, Powers S K
Division of Neurosurgery, University of North Carolina, Chapel Hill, 27514-7060.
J Emerg Med. 1989 Nov-Dec;7(6):603-10. doi: 10.1016/0736-4679(89)90005-x.
Interhemispheric subdural hematoma (IHSDH) usually manifests itself in a delayed fashion after trauma as a slow neurological deterioration with signs of the falx syndrome (paresis or seizures of the lower extremity contralateral to the hematoma). Several etiologies of IHSDH have been described, with tearing of bridging veins being especially associated with trauma. We present the second reported case of IHSDH due to traumatic arterial laceration. This lesion demonstrates a benign and delayed initial presentation. Conservative observation has been employed in the past with mixed results. Patients receiving early definitive surgical treatment have a lower mortality rate then those treated similarly having convexity SDHs. This review of 31 cases discusses the salient aspects of this clinical entity, emphasizing the need for prompt diagnosis and treatment, despite the patient's seemingly stable neurological status.
大脑镰下硬膜下血肿（IHSDH）通常在创伤后延迟出现，表现为缓慢的神经功能恶化，并伴有大脑镰综合征的体征（血肿对侧下肢轻瘫或癫痫发作）。已有多种导致IHSDH的病因被描述，其中桥静脉撕裂尤其与创伤相关。我们报告了第二例因创伤性动脉撕裂导致的IHSDH病例。该病变最初表现为良性且延迟出现。过去采用保守观察，结果不一。与接受类似治疗的凸面硬膜下血肿患者相比，接受早期确定性手术治疗的患者死亡率更低。这篇对31例病例的综述讨论了该临床实体的显著特征，强调尽管患者神经状态看似稳定，但仍需及时诊断和治疗。
