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本院1985～1993年共收治小儿外伤性迟发性跨横窦硬脑膜外血肿5例。笔者结合病例就诊治及发病机制进行讨论。临床资料例1,男,11岁。2小时前从行驶的汽车上摔下,右枕部着地,当即短暂昏迷。伤后30分钟头颅 CT 扫描颅内未见血肿,右枕骨有骨折。伤后9小时因头痛加重,呕吐。复查 CT 显示石侧跨横窦硬脑膜外血肿。生命体征平稳,GCS15分。急诊行右侧跨幕上下联合开颅,术中见颅骨线形骨折,血肿约20ml,予以清除,横窦未破裂,无活跃出血。痊愈。例2,男,15岁。16小时前被文具盒击伤左枕部,当即昏迷15分钟。伤后1小时头颅 CT 扫描颅内未见异常。16小时后因意识障碍再次行头颅 CT,显示左侧跨横窦硬脑膜外血肿。GCS6分。急诊行左侧跨幕上下联合开颅,术中见枕骨线形骨折,硬脑膜外血肿幕上50ml,幕下30ml,横窦破裂5mm,仍在
The hospital from 1985 to 1993 were treated pediatric traumatic delayed transversal sinus epidural hematoma in 5 cases. The author combined with case diagnosis and treatment of pathogenesis for discussion. Clinical data example 1, male, 11 years old. 2 hours ago fell from the driving car, right occipital land, immediately a short coma. 30 minutes after craniocerebral cranial CT scan no hematoma, fracture of the right occiput. Nine hours after the injury due to headache, vomiting. Retrospective CT showed stone lateral transverse sinus dural hematoma. Vital signs of stable, GCS15 points. Across the emergency line on the right transcontinental combined craniotomy, intraoperative see skull linear fracture, hematoma about 20ml, to be cleared, transverse sinus is not broken, no active bleeding. get well. Example 2, male, 15 years old. 16 hours ago was injured pencil box left pillow, immediately coma 15 minutes. 1 hour after craniocerebral CT scan showed no abnormalities in the brain. After 16 hours again due to disturbance of consciousness head CT, showed left transverse sinus dural hematoma. GCS6 points. On the left side of the emergency department, the left-side transcontinental combined craniotomy was performed. The occipital linear fractures were observed in the operation. The epidural hematoma 50 ml, the infratemporal 30 ml, the transverse sinus 6 mm,