Chaoguo You, Xiu Long, Liuxun Hu, Hansong Sheng, Nu Zhang
Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou , China.
J Korean Neurosurg Soc. 2019 Mar;62(2):225-231. doi: 10.3340/jkns.2016.0506.007. Epub 2019 Feb 27.
Epidural haematoma (EDH) most commonly occurs in the supratentorial area, particularly in the temporal region, of the brain. Posterior fossa epidural haematoma (PFEDH) is less frequently observed, accounting for only 1.2% to 12.9% of all EDH cases. Because of the non-specific symptoms and the potential for rapid and fatal deterioration in children, an early computed tomography (CT) scanning is necessary for all suspicious cases. The aim of the present study was to share the experience of 48 cases and review the literature concerning PFEDH.
A retrospective analysis was conducted for 48 paediatric cases diagnosed with PFEDH and admitted to Yuying Children's Hospital of Wenzhou Medical University from January 2010 to August 2015. The clinical features and outcomes were analyzed and compared with previous literature.
Seventeen patients were surgically treated in this series and 31 patients received non-operative treatment. The outcomes were good in 46 patients, evaluated using the Glasgow outcome score (GOS), while mild disability was observed in one patient, and only one case showed severe disability. There were no cases of mortality in this series.
Posterior fossa epidural haematoma is relatively rare compared with supratentorial epidural haematoma. Early and serial CT scans should be performed for all suspicious cases. The criteria for the surgical treatment of paediatric patients with PFEDH were concluded. The overall prognosis was excellent in paediatric patients.
硬膜外血肿（EDH）最常发生于幕上区域，尤其是大脑颞区。后颅窝硬膜外血肿（PFEDH）较少见，仅占所有EDH病例的1.2%至12.9%。由于儿童症状不具特异性且有迅速致命恶化的可能，所有可疑病例均需早期进行计算机断层扫描（CT）。本研究旨在分享48例病例的经验并回顾有关PFEDH的文献。
对2010年1月至2015年8月在温州医科大学附属育英儿童医院收治的48例诊断为PFEDH的儿科病例进行回顾性分析。分析临床特征及转归，并与既往文献进行比较。
本系列中17例患者接受了手术治疗，31例患者接受了非手术治疗。采用格拉斯哥预后评分（GOS）评估，46例患者预后良好，1例患者有轻度残疾，仅1例显示重度残疾。本系列无死亡病例。
与幕上硬膜外血肿相比，后颅窝硬膜外血肿相对少见。所有可疑病例均应早期及多次进行CT扫描。总结了小儿PFEDH患者的手术治疗标准。小儿患者总体预后良好。
