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目的探讨急性静脉源性外伤性硬膜外血肿的诊断与治疗。方法回顾性分析42例急性静脉源性外伤性硬膜外血肿的临床特点、影像学特征及治疗和预后。结果出血来源以静脉窦尤其窦汇横窦乙状窦为主,GOS评分显示30例(71.4%)预后好(GOS4～5),12例(28.6%)预后差(GOS1～3),5例(11.9%)死亡。结论急性静脉源性硬膜外血肿出血患者出血部位、处理方法和术后并发症发生率与动脉源性出血患者不同,预后较差。术前CT显示跨窦骨折、近窦血肿应考虑静脉源性出血。对静脉窦出血患者尤其窦汇横窦出血要及时慎重处理。
Objective To investigate the diagnosis and treatment of acute venous traumatic epidural hematoma. Methods The clinical features, imaging characteristics, treatment and prognosis of 42 cases of acute venous traumatic epidural hematoma were retrospectively analyzed. Results The main source of bleeding was sinuses, especially sinica sigmoid sinus. The GOS score showed good prognosis (GOS4 ~ 5) in 30 cases (71.4%), poor prognosis (GOS1 ~ 3) in 12 cases (11.9%) died. Conclusions The hemorrhage location, treatment method and postoperative complication rate in patients with acute intravenous epidural hematomas are different from those in patients with arterial hemorrhage. The prognosis is poor. Preoperative CT showed transcortical fracture, sinus hemorrhage should be considered venous bleeding. Sinus bleeding in patients, especially sinus bleeding sinus bleeding timely and careful treatment.