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儿童颅内硬脑膜下血肿：流行病学、解剖学及病理生理学

Author
Mark R Proctor, MD
Section Editor
Richard G Bachur, MD
Deputy Editor
James F Wiley, II, MD, MPH
Translators
邢影, 主任医师，副教授

引言

出血进入硬脑膜和蛛网膜之间的潜在空隙时可形成硬脑膜下血肿(subdural hematoma, SDH)。与成人SDH明显不同，儿童SDH，尤其是2岁以下患儿中，受到伤害所致的头部损伤是常见病因[1]。与硬脑膜外血肿(epidural hematoma, EDH)相比，SDH的手术指征还不太清楚，而且手术不太可能防止SDH出现并发症和死亡。(参见“儿童颅内硬膜下血肿：临床特征、评估与治疗”和“儿童颅内硬膜外血肿：临床特征、诊断及治疗”)

本专题将讨论儿童SDH的流行病学、解剖学和病理生理学。儿童及成人SDH的临床特点、评估及处理将单独讨论。(参见“儿童颅内硬膜下血肿：临床特征、评估与治疗”和“成人硬脑膜下血肿：病因、临床表现及诊断”和“成人硬膜下血肿：预后与治疗”)

下表简要总结了儿童SDH的重要临床表现及初步处理(表 1)。

流行病学

儿童SDH的病因因年龄而异。SDH最常发生在婴儿和不到2岁的年幼儿童。

新生儿 — 多达8%的足月分娩可出现SDH，可能与使用真空吸引或产钳助娩相关[2]。此类血肿一般比较小而且通常在4周内消退，其通常是无症状的。

                     

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Literature review current through: 2017-06 . | This topic last updated: 2016-03-02.
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