Sin Eui Gyu
Department of Neurosurgery, Konyang University Hospital, Daejeon, Korea.
J Trauma Inj. 2022 Mar;35(1):43-45. doi: 10.20408/jti.2021.0036. Epub 2022 Feb 22.
Epidural hematoma (EDH) can sometimes be life-threatening, although small-volume EDHs can resolve spontaneously like other intracranial hematomas. However, in rare cases, EDH can transform into a chronic form instead of disappearing. In contrast to subdural hematoma, there is no agreed-upon definition or treatment of chronic EDH. A 41-year-old male patient with acute EDH in the bilateral paravertical area due to partial rupture of the sagittal sinus was operated first, and then remnant contralateral hematoma was treated conservatively. One month after surgery, he showed hemiparesis, and brain imaging revealed chronic EDH at the location of the remnant acute hematoma. We performed surgery again to treat chronic EDH through a large craniotomy. Although many cases of EDH are self-limited, clinicians must keep in mind that some cases of EDH, especially those of venous origin and arising in young people, can become chronic and require surgical treatment.
硬膜外血肿(EDH)有时可能危及生命,尽管小体积的硬膜外血肿可像其他颅内血肿一样自行消退。然而,在罕见情况下,硬膜外血肿会转变为慢性形式而非消失。与硬膜下血肿不同,目前对于慢性硬膜外血肿尚无公认的定义或治疗方法。一名41岁男性患者因矢状窦部分破裂导致双侧旁矢状区急性硬膜外血肿,先行手术治疗,然后对残余的对侧血肿进行保守治疗。术后1个月,他出现偏瘫,脑部影像学检查显示在残余急性血肿部位存在慢性硬膜外血肿。我们再次通过大骨瓣开颅手术治疗慢性硬膜外血肿。尽管许多硬膜外血肿病例是自限性的,但临床医生必须牢记,一些硬膜外血肿病例,尤其是静脉源性且发生于年轻人的病例,可能会发展为慢性并需要手术治疗。