Takeda N, Kurihara E, Matsuoka H, Kose S, Tamaki N, Matsumoto S
Department of Neurosurgery, Social Insurance Ritsurin Hospital, Takamatsu, Japan.
No Shinkei Geka. 1988 Jan;16(1):87-92.
Traumatic acute subdural hematomas over the convexity of the cerebral hemispheres are often encountered, but acute interhemispheric subdural hematomas are rare. Fourty-eight cases of acute subdural hematomas was admitted to our hospital between 1977 and 1986, and three cases of them (6%) were located in the interhemispheric subdural space. In this paper, these three cases are reported with 20 documented cases. Case 1: an 81-year-old female was admitted to our hospital because of headache, nausea and vomiting. She hit her occiput a week ago. CT scan demonstrated contusion in the right frontal lobe and a high density in the interhemispheric space of the right frontal region. Her complaints disappeared gradually by conservative therapy and she returned to her social life. Case 2: a 50-year-old male fell downstairs and hit his vertex. As he lost consciousness, he was admitted to our hospital. He was stuporous and had left-hemiparesis. Skull X-ray film showed fracture line extending from the right temporal bone to the left parietal bone across the midline. CT scan revealed intracerebral hematoma in both frontal lobe and right parietal lobe and subarachnoid hemorrhage in the basal cistern and Sylvian fissure of the right side. And interhemispheric subdural hematoma in the right parietal region was visualized. Angiography demonstrated a lateral displacement of the right callosomarginal artery and an avascular area between the falx and the callosomarginal artery. After admission his consciousness recovered and convulsion was controlled by drug. Left-hemiparesis was improved by conservative therapy and he was discharged on foot.(ABSTRACT TRUNCATED AT 250 WORDS)
创伤性急性硬膜下血肿在大脑半球凸面较为常见,但急性大脑镰下硬膜下血肿却很罕见。1977年至1986年间,我院共收治48例急性硬膜下血肿患者,其中3例(6%)位于大脑镰下硬膜下间隙。本文报告这3例病例,并结合20例文献报道。病例1:一名81岁女性因头痛、恶心和呕吐入院。一周前她枕部受伤。CT扫描显示右额叶挫伤,右额叶大脑镰下间隙高密度影。经保守治疗,她的症状逐渐消失并恢复了社交生活。病例2:一名50岁男性从楼梯上摔下,头部着地。因昏迷入院。他处于昏睡状态,左侧偏瘫。颅骨X线片显示骨折线从右侧颞骨延伸至左侧顶骨并跨越中线。CT扫描显示双侧额叶及右侧顶叶脑内血肿,右侧基底池及外侧裂蛛网膜下腔出血。右侧顶叶大脑镰下硬膜下血肿显影。血管造影显示右侧胼周动脉外侧移位,大脑镰与胼周动脉之间无血管区。入院后他的意识恢复,药物控制了抽搐。经保守治疗,左侧偏瘫有所改善,他步行出院。(摘要截断于250字)