婴幼儿硬脑膜外血肿

目的：探讨婴幼儿硬脑膜外血肿的临床特点。方法回顾性分析了我院近3年来收治的婴幼儿硬脑膜外血肿18例。占同期儿童(15岁以下)硬脑膜外血肿的15％，年龄最小为5个月，全部患儿均行CT或X线平片检查确诊。结果受伤原因以坠落伤为主，血肿部位以顶、枕为主。10例(55．6％10／18)患儿合并有颅骨骨折，原发昏迷者仅1例，所有患儿均有呕吐。除急诊手术者外，其他于首次发现血肿1d后及2～3d左右再复查CT。手术者占50％，发现大多数血肿来源于硬脑膜表面微小血管出血。结论：硬脑膜剥离致表面微小血管出血为婴幼儿硬膜外血肿形成的首要原因，有必要行多次CT检查，治疗恰当则预后良好。

Epidural hematomas in infants

Objective To review the clinical features of epidural hematomas in infants.Methods 18 infants with epidural hematomas managed in the previous three years were reviewed.Results The most common cause of head injury was accidental falls. Most of hematomas were located at the parietal and occipital areas. Skull fractures were reported in 55.6% .There was only one case of primary coma. Vomiting was reported in all cases.The CT scan was repeated within three days in non-operated cases. Hematoma was removed in half of the cases. The most epidural hematomas was caused by the oozing from the small epidural blood vessels.Conclusions Hemorrhage from the small epidural vessels is the main cause of epidural hematomas in infants after a fall. Repeated CT scan is recommended. The prognosis is good if the right treatment initiated early.