颅脑外伤后迟发性硬膜外血肿的CT诊断  

CT scanning for the diagnosis of delayed epidural hematoma following craniocerebrai trauma

作　　者：俞志坚[1] 王保安[1] 刘永艳 

机构地区：[1]南方医科大学珠江医院放射科,广州510282 [2]广东省阳春市妇幼保健院CT室,529600

出　　处：《中华神经医学杂志》2007年第11期1166-1168,共3页Chinese Journal of Neuromedicine

摘　　要：目的探讨反复头颅CT检查诊断迟发性硬膜外血肿的重要性及其检查指征。方法回顾性总结7例发生迟发性硬膜外血肿的颅脑外伤患者的病情发展及头颅CT检查情况。结果7例颅脑外伤患者均有明显的迟发性精神行为改变,发生时间为伤后4～52 h,CT复查均发现了迟发的硬膜外血肿。有5例患者出现了颅骨骨折,5例患者有顽固的剧烈头痛,恶心、呕吐加重患者3例,偏侧瞳孔扩大患者2例。意识障碍及抽搐患者各1例。结论颅脑外伤患者即使首次头颅CT扫描正常或轻度异常,若有颅骨骨折和(或)精神行为改变时,应复查CT以及时发现迟发性的硬膜外血肿。Objective To discuss the importance and indications of recheck cranial CT scan for the diagnosis of delayed epidural hematoma （DEDH）. Methods The disease progress and cranial CT scan findings for 7 cases with DEDH following craniocerebral trauma were retrospectively summarized. Results All the 7 cases had obviously delayed psychological and behavioral changes which happened within 4-52 h after craniocerebral trauma, and recheck CT scan detected DEDH in all of them. Skull fracture was found in 5 cases, intractable severe headache also in 5 cases, deteriorated nausea and vomiting in 3 cases, unilateral mydriasis in 2 cases and consciousness disturbance and convulsion in a respective 1 case. Condusion Recheck CT scan should be performed on patients with craniocerebral trauma to promptly demonstrate the existence of DEDH if the patient develops skull fracture and/or obvious psychological and behavioral changes, although no abnormality or only insignificant abnormality has been revealed by the first cranial CT scan.

关 键 词：颅脑损伤 迟发性硬膜外血肿 CT扫描 

分 类 号：R651.15[医药卫生—外科学]