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创伤后双侧额顶叶硬膜外血肿伴上矢状窦分离:一例报告并文献复习

Post-Traumatic Bifrontoparietal Extradural Hematoma with Superior Sagittal Sinus Detachment: A Case Report and Review of the Literature.

作者信息

Giannakaki Venetia, Triantafyllou Triantafyllos, Drossos Dimitrios, Papapetrou Konstantinos

机构信息

Neurosurgical Clinic, Lamia General Hospital, Lamia, Fthiotida, Greece; Department of Neurosurgery, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom.

Neurosurgical Clinic, Lamia General Hospital, Lamia, Fthiotida, Greece.

出版信息

World Neurosurg. 2016 Sep;93:489.e17-20. doi: 10.1016/j.wneu.2016.06.085. Epub 2016 Jun 28.

Abstract

OBJECTIVE

To present, to our knowledge, the first case of a single bilateral extradural hematoma due to superior sagittal sinus detachment that was treated conservatively with an excellent outcome.

METHODS

Bilateral extradural hematomas are a rare condition, accounting for only 2%-5% of all extradural hematomas. They can be either 2 distinct hematomas on either side or 1 single bilateral hematoma mostly due to sagittal sinus injury, with the latter being the most rare owing to the firm attachment of the sinus to its subperiosteal loggia. These hematomas usually require immediate surgical evacuation, as patients present with decreased level of consciousness, and have good postoperative outcomes. We present a bilateral extradural hematoma due to superior sagittal sinus injury, which was treated conservatively.

RESULTS

The patient had an excellent recovery, with no residual neurological deficits and a Glasgow outcome scale of 5 on discharge.

CONCLUSION

Bilateral extradural hematomas due to superior sagittal sinus injury almost always require surgical intervention. We present a patient who was treated conservatively with an excellent outcome and we also perform a review of the current literature.

摘要

目的

据我们所知,本文报告首例因上矢状窦分离导致的单侧双侧硬膜外血肿,该病例采用保守治疗,效果良好。

方法

双侧硬膜外血肿是一种罕见情况,仅占所有硬膜外血肿的2%-5%。它们可以是两侧的两个不同血肿,也可以是一个单侧双侧血肿,主要是由于矢状窦损伤,后者由于窦与其骨膜下腔紧密相连而最为罕见。这些血肿通常需要立即手术清除,因为患者会出现意识水平下降,且术后效果良好。我们报告一例因上矢状窦损伤导致的双侧硬膜外血肿,采用保守治疗。

结果

患者恢复良好,无残留神经功能缺损,出院时格拉斯哥预后评分5分。

结论

因上矢状窦损伤导致的双侧硬膜外血肿几乎总是需要手术干预。我们报告了一例采用保守治疗且效果良好的患者,并对当前文献进行了综述。

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