颅骨切开术：改良颅骨切开术治疗中线硬膜外血肿。病例系列。
Book craniotomy: modified craniotomy for midline extradural hematoma. Patient series.
作者信息
Senapati Satya Bhusan, Acharya Abhijit, Puppala Sumirini, Mahapatra Ashok K
机构信息
Department of Neurosurgery, IMS & SUM Hospital, SOA University, Bhubaneswar, Odisha, India.
Department of Neurology, VMMC and Safdarjung Hospital, New Delhi, India.
出版信息
J Neurosurg Case Lessons. 2025 Apr 28;9(17). doi: 10.3171/CASE2518.
BACKGROUND
An extradural hematoma (EDH) is an acute blood collection between the dura and calvarium in the skull and the spine. The most common cause is traumatic and the most common location is the temporal convexity. A midline or vertex EDH from a venous bleed, most commonly from the midline sinuses, is rare.
OBSERVATIONS
The authors present a case series of 9 cases of vertex EDH managed in their department.The common cause was road traffic accidents. Vertex EDH was the most common type. Book craniotomy was considered in all cases. A definite sinus injury was seen in 5 cases. No patients died. Book craniotomy is an innovative method to manage midline EDH when there is a risk of sinus injury.
LESSONS
A midline EDH is not common and needs special attention. Surgical treatment can lead to profuse blood loss due to an underlying sinus injury and patient morbidity. Book craniotomy is an innovative method to safeguard the sinuses in cases of midline EDH and achieve hemostasis. https://thejns.org/doi/10.3171/CASE2518.
背景
硬膜外血肿（EDH）是指颅骨和脊柱硬脑膜与颅骨之间的急性血肿。最常见的病因是外伤，最常见的部位是颞叶凸面。中线或顶点硬膜外血肿由静脉出血引起，最常见于中线窦，较为罕见。
观察结果
作者介绍了其科室收治的9例顶点硬膜外血肿病例系列。常见病因是道路交通事故。顶点硬膜外血肿是最常见的类型。所有病例均考虑行骨瓣开颅术。5例可见明确的窦损伤。无患者死亡。当存在窦损伤风险时，骨瓣开颅术是治疗中线硬膜外血肿的一种创新方法。
经验教训
中线硬膜外血肿并不常见，需要特别关注。手术治疗可能因潜在的窦损伤导致大量失血和患者发病。骨瓣开颅术是在中线硬膜外血肿病例中保护窦并实现止血的一种创新方法。https://thejns.org/doi/10.3171/CASE2518
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