Ortiz-Ordonez Andrea, Jiménez-Deleg Geovanny, Salman Saif
Neurological Surgery, Universidad San Francisco de Quito, Colegio Ciencias de la Salud, calle Diego de Robles s/n y Pampite, 170901, Quito, ECU.
Neurological Surgery, Universidad San Francisco de Quito USFQ, Colegio Ciencias de la Salud, calle Diego de Robles s/n y Pampite, 170901, Quito, ECU.
Cureus. 2021 Jan 13;13(1):e12686. doi: 10.7759/cureus.12686.
Cranial epidural hematoma is a serious event requiring immediate intervention. This can be due to sudden traction tearing the vessels between the dura and the skull. During posterior fossa surgery, brain collapse may emerge due to the sudden reduction of prolonged elevated intracranial pressure; it could cause dura-skull detachment to create epidural hematoma even far from the surgical site. Hence, we should be aware of this complication when approaching posterior fossa tumors as it frequently leads to severe neurologic impairment or death. Here, we report a 12-year old previously healthy child who was admitted with a 4-month history of severe headache, vomiting, and right eye blindness due to increased intracranial pressure. A brain Computed Tomography (CT) scan showed obstructive hydrocephalus, and contrast-enhanced Magnetic Resonance Imaging (MRI) confirmed intraventricular posterior fossa tumor. After tumor resection, the patient developed an epidural hematoma far from the surgery site. Removal of the hematoma exposed lacerations of superior sagittal sinus due to dural detachment. Failure to control intracranial pressure resulted in a fatal outcome.
颅骨硬膜外血肿是一种需要立即干预的严重情况。这可能是由于突然的牵拉导致硬脑膜和颅骨之间的血管撕裂。在后颅窝手术期间，由于长期升高的颅内压突然降低，可能会出现脑塌陷；这可能导致硬脑膜与颅骨分离，即使在远离手术部位的地方也会形成硬膜外血肿。因此，在处理后颅窝肿瘤时，我们应该意识到这种并发症，因为它经常导致严重的神经功能损害或死亡。在此，我们报告一名12岁以前健康的儿童，因颅内压升高入院，有4个月的严重头痛、呕吐和右眼失明病史。脑部计算机断层扫描（CT）显示梗阻性脑积水，对比增强磁共振成像（MRI）证实为后颅窝脑室内肿瘤。肿瘤切除后，患者在远离手术部位处出现硬膜外血肿。血肿清除后发现由于硬脑膜分离导致上矢状窦撕裂。未能控制颅内压导致了致命的结果。
