Koppen Hille, Arkink Enrico, Nordbeck Anna, Sie Lilian, van der Gaag Niels
Hagaziekenhuis, Department of Neurology, The Hague, The Netherlands.
Leiden University Medical Center, Department of Neurology, Leiden, The Netherlands.
Case Rep Neurol. 2019 Dec 16;11(3):351-356. doi: 10.1159/000504468. eCollection 2019 Sep-Dec.
We report the case of a 4-year-old girl with acute subdural hematoma who presented to the emergency department after an unwitnessed fall of the balcony. The hematoma was hyperdense along the left convexity of 9 mm thickness with a consequent mass effect with obliteration of the adjacent sulci, left lateral ventricle compression and a midline shift of 7 mm. During her stay in the emergency department while waiting for transfer to the children intensive care unit elsewhere she slightly deteriorated neurologically. Repeat CT scan of the brain 4 h after initial presentation remarkably showed that the subdural hematoma had now largely disappeared, with a decrease in volume and density. Consequently, the mass effect diminished with a near normalization of the midline shift.
我们报告了一名4岁女童的病例，她在无人目睹的情况下从阳台坠落，之后被送往急诊科。血肿沿左侧脑凸面呈高密度，厚度为9毫米，伴有相应的占位效应，导致相邻脑沟消失、左侧脑室受压以及中线移位7毫米。在她留在急诊科等待转往其他地方的儿童重症监护病房期间，其神经功能略有恶化。初次就诊4小时后重复进行脑部CT扫描，结果显示硬膜下血肿现已基本消失，体积和密度均有所减小。因此，占位效应减弱，中线移位几乎恢复正常。
