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斜坡后硬膜外血肿:一种需怀疑的诊断。三例报告并文献复习

Retroclival epidural haematoma: a diagnosis to suspect. Report of three cases and review of the literature.

作者信息

Zabalo Gorka, Ortega Rodrigo, Díaz Jorge, Vázquez Alfonso, de Frutos Daniel, García Juan Carlos, Zazpe Idoya

机构信息

Department of Neurosurgery, Complejo Hospitalario de Navarra, c/ de Irunlarrea 3, planta baja, 31008, Pamplona, Navarra, Spain.

出版信息

Acta Neurochir (Wien). 2017 Aug;159(8):1571-1576. doi: 10.1007/s00701-017-3214-0. Epub 2017 May 20.

Abstract

Retroclival epidural haematoma (REDH) has been reported infrequently. It is a rare entity which is probably underdiagnosed. It is most commonly seen in the paediatric population and is generally associated with high-velocity injuries. We report three cases of paediatric patients diagnosed with REDHs: two of them secondary to high-energy trauma related to a motor-vehicle accident and the other a low-energy trauma after a slip while playing football. All three patients were managed conservatively by cervical immobilisation with favourable outcome. REDH is probably underdiagnosed by computed tomography scan. When the suspicion is high, sagittal reconstructions or magnetic resonance imaging should be considered to confirm the diagnosis. Usually, it is related to hyperflexion or hyperextension cervical injuries secondary to motor vehicle accident. However, it can also be observed in milder injuries.

摘要

斜坡后硬膜外血肿(REDH)的报道较少。它是一种罕见的病症,可能存在漏诊情况。多见于儿童群体,通常与高速损伤有关。我们报告了3例诊断为REDH的儿科患者:其中2例继发于与机动车事故相关的高能创伤,另一例是踢足球时滑倒后的低能创伤。所有3例患者均通过颈部固定进行保守治疗,预后良好。REDH可能通过计算机断层扫描被漏诊。当高度怀疑时,应考虑进行矢状面重建或磁共振成像以确诊。通常,它与机动车事故继发的颈椎过度屈曲或伸展损伤有关。然而,在较轻的损伤中也可观察到。

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