非常见部位急性硬膜下血肿CT诊断(附26例报告)

目的　提高对非常见部位急性硬膜下血肿CT表现的认识。方法　头颅外伤后在 2 4h内行CT检查 1 9例 ,2～ 3d内行CT检查 7例。经治疗后在 1～ 4周内复查CT。结果　单纯表现为大脑镰急性硬膜下血肿 7例 ,小脑幕急性硬膜下血肿 5例。额颞底部急性硬膜下血肿 2例。脑挫裂伤、脑内血肿伴有大脑镰急性硬膜下血肿 3例 ,伴有小脑幕急性硬膜下血肿 2例 ,颞顶部急性硬膜下血肿伴有大脑镰急性硬膜下血肿 2例 ,大脑镰、小脑幕急性硬膜下血肿伴有蛛网膜下腔出血 5例。 2 6例大脑镰与小脑幕急性硬膜下血肿均发生在单侧。大脑镰急性硬膜下血肿的形态有的在中线呈细线状 ,有的呈粗线状。血肿厚度 0 .3～ 1 .5cm不等。小脑幕急性硬膜下血肿表现为片状、新月形。结论　大脑镰、小脑幕和额颞底部急性硬膜下血肿是发生在少见部位的特殊类型急性硬膜下血肿 ,只要对此类血肿有所认识 ,CT检查不难确诊 ,但有时需要与蛛网膜下腔出血鉴别

CT Diagnosis of Acute Subdural Hematoma in The Rare Region(a reprot of 26 cases)

Objective To improve the knowledge of acute subdural hemorrhage located in the rare region. Methods 19 cases were examined within 1 day after trauma, 7 cases were examined within 2 to 3 days after trauma and follow-up CT scan was performed on 26 patients 1 to 4 weeks later. Results Bleeding only in subdural space cerebral falx or tentorium occurred in 7 and 5, 2 cases bleeding located in the base of frontotemporal region. 12 cases hemorrhage in cerebral falx or tentorium accompanyed with contusion of brain, intracranial hematom, subdural or subarachnoid hemorrhage. Subdural hemmtoma of cerebtal longitudinal fissure appeared as liear or bandlike hyperattenuation and was about 0.3 to 1.5 cm in thickness, subdural hemorrhage of tentorium findinged as patchy, crescent hyperattenuation. All of these lesion located in the same side of the cranial cavity. Conclusion Subdural hematoma of interhemipheric fissure, tentorum of cerebellum or the bottom frontotemporal lobe was a kind of subdural hemorrhage in special site, as soon as their CT appearances were knew, special subdural hematoma can be diagnosed, but should be diffrentiated from subarachnoid hemorrhage.