Habash A H, Sortland O, Zwetnow N N
Acta Neurochir (Wien). 1982;60(1-2):7-27. doi: 10.1007/BF01401746.
35 patients with epidural bleeding operated on at Rikshospitalet, Oslo, during the period 1965-1980 had preoperative angiography with visualization of the external carotid artery. Twenty-one patients had extravasation of contrast medium from meningeal arteries. Seventeen of the 21 had also shunting of contrast medium from meningeal arteries to meningeal or diploic veins, while 20 of the 21 also had bled from a ruptured meningeal artery at operation. It was further found that of 20 patients who deteriorated after trauma 18 had an epidural arteriovenous shunt or extravasation. Conversely, of 15 patients who improved after trauma 12 had no evidence of a shunt. The strong correlation between the clinical course and the occurrence of extravasation supports previous experimental and clinical data, indicating the epidural arteriovenous shunt to be a major factor in the pathophysiology and the outcome of epidural bleeding.
1965年至1980年期间，在奥斯陆里克斯医院接受硬膜外出血手术的35例患者进行了术前血管造影，可见颈外动脉。21例患者的脑膜动脉有造影剂外渗。这21例中的17例同时有造影剂从脑膜动脉分流至脑膜或板障静脉，而21例中的20例在手术时也有脑膜动脉破裂出血。进一步发现，20例创伤后病情恶化的患者中有18例存在硬膜外动静脉分流或造影剂外渗。相反，15例创伤后病情好转的患者中有12例没有分流迹象。临床病程与造影剂外渗的发生之间的强相关性支持了先前的实验和临床数据，表明硬膜外动静脉分流是硬膜外出血病理生理学和预后的主要因素。
