颅脑手术后非手术区急性硬脑膜外血肿

目的探讨颅脑手术后非手术区急性硬脑膜外血肿发生的原因及预防措施和治疗方法.方法回顾性分析10例非手术区急性硬脑膜外血肿发生的特点.结果5例为术野临近部位血肿,5例为远隔部位血肿.10例均行手术清除血肿,1例死亡.结论颅脑术后非手术区急性硬脑膜外血肿发生的可能原因是打开骨瓣时,脑组织连带硬脑膜向骨窗口膨出,造成硬脑膜和颅骨剥离出血.术前、术中降低颅压可预防.术中遇到无法解释的急性脑膨出或术后苏醒迟缓、昏迷、脑疝应急行CT检查,清除血肿.

Acute postoperative epidural hematoma following the craniotomy in non-operation area

Objective To summarize the causes,prophylaxis and therapy of acute postoperative epidural hematoma following the craniotomy in non operation area.Methods Acute postoperative epidural hematoma in 10 patients who were treated at Tiantan Hospital were studied.Results Five patients had contralateral epidural hematoma,five had epsilateral epidural hematoma near the operative area.The craniotomy was done to remove the hematoma in all patients.One died.Conclusions The massive epidural hematoma is probably caused by dura skull detachment when the skull bone is opened and dura brain moves to the window.The risk factors include young or middle age,high intracranial pressure,sudden decompression,and medium or large bone window.The patients who suffered from high intracranial pressure should be decompressed before operation.During operation,before openning the bone,the intracranial pressure must be decompressed slowly.When unexplained sudden brain swelling,delayed awaking or coma happened,an emergency CT scan must be done.Hematomas should be removed.