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目的探讨后颅窝跨横窦的硬膜外血肿临床特点、手术治疗策略和治疗体会。方法回顾性分析我院2000年1月～2010年8月收治的22例后颅窝跨横窦硬膜外血肿患者的临床资料。结果 22例后颅窝跨横窦硬膜外血肿患者都经手术治疗,术后第3～6d头部CT扫描显示血肿无复发、血肿清除良好,骨瓣无移位。出院时GOS预后评分:恢复良好15例,中残4例,重残2例,死亡1例。结论后颅窝跨横窦型硬膜外血肿患者病情复杂多变,手术治疗应充分估计出血范围,根据具体情况选择骨窗、骨瓣或两者相结合的手术方式。手术时机、术前状态、原发伤的轻重和术中处理是影响预后的重要因素。
Objective To investigate the clinical features, surgical treatment strategies and treatment of epidural hematoma in the posterior cranial fossa. Methods The clinical data of 22 patients with posterior fossa transdiaphragmatic epidural hematoma admitted to our hospital from January 2000 to August 2010 were retrospectively analyzed. Results Twenty - two cases of posterior fossa transdiaphragmatic epidural hematomas were surgically treated. The CT scans on the 3rd to 6th days after operation showed no recurrence of hematoma, good hematoma clearance and no displacement of the bone flap. GOS prognostic score at discharge: 15 were well recovered, 4 were moderate disability, 2 were severe disability, and 1 was death. Conclusion The posterior fossa transversal sinus type of epidural hematoma patients complicated and varied, surgical treatment should be fully estimated bleeding range, depending on the specific circumstances choose the bone window, bone flap or a combination of both surgical approach. The timing of surgery, preoperative status, severity of primary injury, and intraoperative management are important prognostic factors.