儿童后颅窝跨横窦硬膜外血肿51例诊治分析

程杨; 梁平; 李映良; 翟瑄; 李禄生; 周渝冬; 周建军

doi:10.16016/j.1000-5404.201801148

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儿童后颅窝跨横窦硬膜外血肿51例诊治分析

临床医学 | 更新时间：2026-01-09

- 儿童后颅窝跨横窦硬膜外血肿51例诊治分析
- Treatment and diagnosis for posterior fossa epidural hematomas straddling transverse sinus in children: an analysis of 51 cases
- 第三军医大学学报 2018年40卷第15期页码：1424-1428
- 作者机构：
  
  400014 重庆, 重庆医科大学附属儿童医院神经外科, 儿童发育疾病研究省部共建教育部重点实验室, 儿科学重庆市重点实验室, 重庆市儿童发育重大疾病诊治与预防国际科技合作基地
- 作者简介：
  
  [ 梁平, E-mail:liangping868@sina.com LIANG Ping, E-mail:liangping868@sina.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201801148
  中图分类号： R181.32;R726.511.5
- 收稿：2017-01-17，
  
  修回：2018-04-07，
  
  纸质出版：2018-08-15
- 稿件说明：
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程杨, 梁平, 李映良, 等. 儿童后颅窝跨横窦硬膜外血肿51例诊治分析[J]. 第三军医大学学报, 2018,40(15):1424-1428.

Yang CHENG, Ping LIANG, Yingliang LI, et al. Treatment and diagnosis for posterior fossa epidural hematomas straddling transverse sinus in children: an analysis of 51 cases[J]. Journal of Third Military Medical University, 2018, 40(15): 1424-1428.
程杨, 梁平, 李映良, 等. 儿童后颅窝跨横窦硬膜外血肿51例诊治分析[J]. 第三军医大学学报, 2018,40(15):1424-1428. DOI： 10.16016/j.1000-5404.201801148.

Yang CHENG, Ping LIANG, Yingliang LI, et al. Treatment and diagnosis for posterior fossa epidural hematomas straddling transverse sinus in children: an analysis of 51 cases[J]. Journal of Third Military Medical University, 2018, 40(15): 1424-1428. DOI： 10.16016/j.1000-5404.201801148.

摘要

目的

探讨儿童后颅窝跨横窦硬膜外血肿的临床表现、影像学特征及手术指征。

方法

回顾性收集本院神经外科2010年1月至2016年12月收治的51例儿童后颅窝跨横窦硬膜外血肿的临床资料，分析包括年龄、就诊时间、致伤原因、临床表现、影像学表现、治疗方式等不同指标的特点及其与疾病的关系。

结果

本组51例患儿，>3岁48例，30例为跌伤，受伤至就诊时间（30.7±18.9）h，临床表现不典型，主要为恶心呕吐、精神差、头痛，常无意识障碍，头颅CT提示急性期血肿易液化（84.3%）。12例行非手术治疗，39例行手术治疗，其中6例为后颅窝微小血肿（血肿量 < 5 mL），12例为非手术治疗的中转手术。随访3个月至3年，全部患儿恢复良好，无死亡及致残。

结论

儿童后颅窝跨横窦硬膜外血肿好发于学龄前期及学龄期的儿童；血肿量>10 mL，血肿厚度>15 mm，血肿存在占位效应，非手术治疗过程中血肿增大的患儿有手术指征；对伴有高颅压表现的静脉窦区域小血肿（< 5 mL）应积极手术。

Abstract

Objective

To investigate the clinical features

imaging findings and surgical indications of posterior fossa epidural hematomas straddling transverse sinus in children.

Methods

A retrospective study was conducted on 51 children with posterior fossa epidural hematomas straddling transverse sinus admitted to our department from January 2010 to December 2016. The characteristics of different indices

such as age

admission time

cause of injury

clinical manifestations

imaging findings and treatment and their relationships with the disease were analyzed.

Results

Among the 51 patients

there were 48 over 3 years old

and 30 got injured by falling. The mean time from injuring to admission of all patients was 30.7±18.9 h. The clinical manifestations were atypical

mainly including nausea and vomiting

headache

low spirit

but without conscious disturbance. The cerebral CT images suggested that the hematomas (84.3%) were prone to liquefaction in acute stage. Twelve cases were treated with conservative managements

and the rest 39 cases received surgical treatment

including 6 were posterior fossa epidural micro hematomas (volume < 5 mL) and 12 with acute clinical deterioration during conservative treatment. During the follow-up of 3 months to 3 years

all children recovered well without death and disability.

Conclusion

Posterior fossa epidural hematomas straddling transverse sinus are common in the pre-school and school age children. The hematomas have a volume of >10 mL

thickness of >15 mm

and obviously mass effect. There are indications of operation for the children with the hematoma are increasing progressively during conservative treatment. For those with small hematoma (< 5 mL) but high intracranial pressure

surgical treatment should be taken immediately.

关键词

Keywords

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