创伤性上部和下部外侧血瘤的延迟呈现:一个说明性的案例
Journal of neurosurgery. Case lessons
|November 13, 2023
概括
上和下外皮质血瘤 (SIEDHs) 很少见,但可能在头部创伤后出现延迟. 及时成像对于及时诊断和在这些关键病例中进行手术干预至关重要.
科学领域:
- 神经外科 神经外科
- 神经辐射学神经辐射学
- 创伤外科 手术 创伤外科
背景情况:
- 额外外外出血瘤 (SIEDH) 是一种罕见的额外外外出血瘤 (EDH) 亚型,占所有EDH的不到2%.
- 这些病变可以迅速扩大并导致神经衰减,需要及时诊断和手术治疗.
研究的目的:
- 要突出SIEDH在头部创伤患者中延迟呈现的潜力.
- 强调在差异诊断中考虑SIEDH的重要性,即使有延迟症状.
主要方法:
- 一个病人的病例报告呈现>48小时后不的头部创伤与延迟的SIEDH症状.
- 通过头部计算机断层扫描 (CT) 进行诊断成像,发现3厘米SIEDH具有显著的质量效应.
- 紧急手术减压和修复一个骨折的头骨骨与网状头骨整形.
主要成果:
- 患者出现了延迟的症状,包括吐和伤,但仍然保持了格拉斯哥昏迷表得分15.
- 手术探索确定了一个从横侧鼻脉的流血静脉是出血的来源.
- 手术后的成像和随访显示了患者的良好康复.
结论:
- 尽管SIEDH很罕见,但它可能会出现延迟发病和神经学上完整的表现.
- 对于有创伤史的患者,建议在持续静脉鼻附近进行低值成像,以排除延迟出血.
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