外伤性后颅窝血肿手术治疗分析

目的　探讨外伤性后颅窝血肿的临床特征和手术疗效。方法　回顾总结 1995～ 1998年手术治疗的 15例后颅窝血肿。结果　患者有枕骨骨折 13例 ;后颅窝硬膜外血肿 11例 ,其中骑跨性 7例 ;小脑半球脑挫伤伴血肿4例 ;后颅窝血肿伴有大脑半球挫伤 4例 ,伴发急性脑积水 5例。患者意识障碍较轻 ,呈进行性加重。手术后恢复良好 10例 ,残留较严重神经系统症状 2例 ,死亡 3例。结论　外伤性后颅窝血肿病情紧急而危重 ,早期诊断、及时手术是抢救成功的关键。

Clinical Analysis of Surgical Treatment of Traumatic Hematomas of the Posterior Cranial Fossa

Objective To discuss the clinical features and surgical outcome of the traumatic hematomas posterior cranial fossa.Methods Fifteen patients with traumatic hematomas posterior cranial fossa in our hospital during the period from 1995 to 1998 were reviewed.Results Thirteen patients had an occipital skull fracture,11 pure epidural hematomas among whom 4 had cerebellar contusion and hematomas 4 posterior cranial fossa hematoma with associated cerebral hematoma or contusion,and 5 acute hydrocephalus.Fifteen patients were treated by emergency surgery,9 had good recovery and 1 had severe disability in GCS between 9 and 15 marking,1 had good recovery,1 had severe disability and 3 died in GCS between 3 and 8.Nine patients had good recvoery in 11 patient having pure epidural hematoma of posterior cranial fossa.Conclusions The clinical course of the traumatic hematomas posterior cranial fossa was acute and severe.The GCS value below 9 predictes the poor outcome for patients.Early diagnosis and appropriatedly and promptly treatment are crucial for achieving good results.