标题：儿童外伤性后颅窝血肿的手术治疗

      作者：杨建军，杨德智，刘 浩，蒲祖煜
    （新晃县人民医院神经外科，湖南 新晃 419200）

      卷次： 2013年24卷11期

      【摘要】 目的 探讨儿童外伤性后颅窝血肿的临床特点、诊断、手术治疗方法及预后。方法 回顾性分析
18例行手术治疗的儿童外伤性后颅窝血肿患者的临床诊治资料。结果 后颅窝硬膜外血肿14例，其中单侧血
肿12例，双侧2例，血肿跨横窦2例；硬膜下血肿3例；小脑血肿1例。合并额颞部硬膜下血肿2例，合并额部硬膜
下血肿2例。梗阻性脑积水6例，第四脑室环池受压移位7例，环池消失2例。术后死亡2例。术后6个月，16例
患者获得随访，其预后按GOS分级：2分1例，3分3例，4分5例，5分7例。结论 外伤性后颅窝硬膜外血肿病情
危重，病情发展快，对有手术指征的病例，及时、合理的选择手术治疗是挽救患儿生命，改善预后的关键。

      【关键词】 后颅窝；血肿；儿童；手术

      【中图分类号】 R726.1 【文献标识码】 A 【文章编号】 1003—6350（2013）11—1690—02


Surgical treatment for patients with traumatic hematomas of the posterior cranial fossa in children.
YANG
Jian-jun, YANG De-zhi, LIU Hao, PU Zu-yu. Department of Neurosurgery, the People's Hospital of Xinhuang County,
Xinhuang, Hunan 419200, CHINA

【Abstract】 Objective To explore the clinical features ,diagnosis ,the surgical treatment methods and the clin-
ic outcome for patients with traumatic hematomas of the posterior cranial fossa in children. Methods From January
2004 to December 2011, 18 patients with traumatic hematomas of the posterior cranial fossa were treated by surgical
operations, and the clinical data of these patients were analyzed retrospectively. Results Of total 18 cases, the epidur-
al hematoma located at unilateral posterior cranial fossa was found in 12 cases , located at bilateral posterior cranial
fossa was found in 2 cases and the hematoma riding transverse sinuses was found in 2 cases. The epidural hematoma
was found in 3 cases and cerebellar hematoma was found in 1case. The complication of subdural hematoma in frontal
and temporal lobes was found in 2 cases and complication subdural hematoma in frontal lobe was found in 2 cases.
Acute noncommunicating hydrocephalus was found in 6 case, the fourth ventricle markedly deformed and/or dis-
placed was seen in 7 cases and the ambient cistern can’t visualized was found in 2 case. Two patients died after sur-
gery. The 16 follow-up survivors were evaluated by Glasgow Outcome Scale (GOS) 6 months after surgery, GOS 2
was found in 1 cases, GOS 3 in 3 cases, GOS 4 in 5 cases, GOS 5 in 7 cases. Conclusion The traumatic hematomas
of posterior cranial fossa in children was an emergency and serious disease. According to the clinical symptoms, physi-
cal sign and situation of the hematoma, it's the key to improve prognosis of patients, who having operation indications,
by means of taking prompt and rational surgical treatment methods after early diagnosis.

      【Key words】 Posterior cranial fossa; Hematoma; Surgery; Children