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[自发性硬膜外血肿——两例报告]

[Spontaneous epidural hematoma--report of two cases].

作者信息

Sekimoto T, Nakagawa Y, Ueda S, Hirakawa K, Fukuma S, Taketomo S

出版信息

No Shinkei Geka. 1985 Nov;13(11):1253-7.

PMID:4088448
Abstract

We report two cases of spontaneous epidural hematoma associated with the hemorrhagic diathesis and the paranasal sinusitis. Case 1: A 31-year-old man with a history of subtotal gastrectomy because of gastric cancer. He complained of headache at left temporal region, but CT scan showed no abnormal finding. After about 12 hours, he was found in comatose state. Emergency CT scan showed left epidural hematoma. He had the thrombocytemia and hemorrhagic diathesis which were supposed to be the side effect of the chemotherapy or DIC. Although the epidural hematoma was removed at emergency, he died 5 days after the operation, because of severe brain swelling. Case 2: A 34-year-old woman with a history of paranasal sinusitis. At 3 weeks after her fourth delivery, she had a headache and a right orbital swelling. She was admitted to the otorhinolaryngologist under the diagnosis of the acute paranasal sinusitis and orbital phlegmone. After admission, the level of consciousness became worse, she was given neurosurgical consultation. Angiogram showed right temporal mass lesion. At operation, the epidural hematoma was found and evacuated. She was discharged without any neurological deficits.

摘要

我们报告两例与出血素质和鼻窦炎相关的自发性硬膜外血肿病例。病例1:一名31岁男性,有因胃癌行胃大部切除术史。他主诉左侧颞部头痛,但CT扫描未发现异常。约12小时后,他被发现处于昏迷状态。急诊CT扫描显示左侧硬膜外血肿。他存在血小板减少症和出血素质,推测是化疗或弥散性血管内凝血的副作用。尽管急诊时清除了硬膜外血肿,但他术后5天因严重脑肿胀死亡。病例2:一名34岁女性,有鼻窦炎病史。在第四次分娩后3周,她出现头痛和右侧眼眶肿胀。她因急性鼻窦炎和眶蜂窝织炎的诊断被收治于耳鼻喉科医生处。入院后,意识水平变差,她接受了神经外科会诊。血管造影显示右侧颞部有占位性病变。手术时发现并清除了硬膜外血肿。她出院时没有任何神经功能缺损。

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