急性创伤性脑下血液瘤的延迟,灾难性扩张:一个案例系列
Shivani Bindal1, William Walker Wroe1, William Dow2
1Department of Neurosurgery, The University of Texas Health Science Center at Houston, Texas, USA.
概括
急性创伤性脑下血液瘤 (SDH) 的延迟扩张是罕见的,即使在72小时后. 及时头部成像在症状出现时至关重要,无论伤害时间如何,以评估潜在的扩张.
科学领域:
- 神经外科 神经外科
- 创伤护理 创伤护理
- 放射学 放射学是一门学科.
背景情况:
- 急性创伤性脑下血液瘤 (SDH) 在受伤后72小时以上的灾难性扩张非常罕见.
- 现有的文献主要由孤立的病例报告组成.
研究的目的:
- 报告最多的SDH扩张延迟患者系列.
- 评估与这种罕见现象相关的发病率和临床因素.
主要方法:
- 无症状急性创伤性SDH病例的回顾性审查,保守地管理.
- 纳入标准:非手术性SDH,格拉斯哥昏迷量表 (GCS) ≥14,症状扩展超过受伤72小时.
- 在一个单一的学术三级创伤中心5年内进行的研究.
主要成果:
- 九名患者符合纳入标准;中位数年龄为80.1岁.
- 低速度下降是常见的机制;最初的SDH大小在3-16毫米之间.
- 扩张的中位时间为4.5天,平均最终SDH大小为20.8毫米.
结论:
- 由于SDH扩张超过72小时,严重神经结果的风险非常低.
- 头部成像应在症状出现后立即进行,不管自受伤以来已经过去了多少时间.
- 早期成像有助于及时评估和管理决策.
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