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儿童颅内硬膜外血肿：临床特征、诊断及治疗

Authors
Edward S Ahn, MD
Mark R Proctor, MD
Section Editor
Richard G Bachur, MD
Deputy Editor
James F Wiley, II, MD, MPH
Translators
刘劲芳, 副教授

引言

硬膜外血肿(epidural hematoma, EDH)是指出血进入硬脑膜与其上颅骨内板间的腔隙内，其原因几乎均为创伤。随着颅内血肿扩大并使硬脑膜脱离颅骨，脑部占位效应可导致并发症和死亡。处理儿童的EDH时需要有关血肿部位和临床表现的专门知识。及时诊断及神经外科会诊是成功治疗EDH的关键。

本专题将探讨儿童EDH的临床特征、诊断及治疗。儿童EDH的流行病学、解剖学及病理生理学，以及成人EDH参见其他专题。 (参见“儿童颅内硬膜外血肿：流行病学、解剖学及病理生理学”和“成人颅内硬膜外血肿”)

临床特征

表中提供了儿童EDH临床特征、诊断性评估及紧急治疗方案的简短总结(表 1)。

需关注的病史 — 判定EDH风险增加的病史特征包括：

●高危创伤机制–当出现以下高危创伤机制时都应注意EDH，即使是最初一般状况良好的儿童：从极高处[>10英尺或2-3倍于患儿的身高]坠落、涉及机动车辆的任何机制，或者颞部或枕部区域受到直接打击。值得注意的是，即使是相对次要的头部损伤机制也可导致年幼婴儿发生严重的创伤性脑损伤，包括EDH。此类患者中轻微头部创伤的评估将单独详细讨论。 (参见“婴儿和儿童的头部轻微创伤：评估”，关于‘2岁以下’一节)

                           

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Literature review current through: 2017-06 . | This topic last updated: 2016-11-08.
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