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颅脑损伤行开颅手术后并发非手术区延迟性颅内血肿(Delayed traumatil intracerebralhematomas, DTICH)为延迟性外伤后颅内血肿的一种类型。它不同于手术侧颅内出血。本院自1985年10月至1995年10月手术治疗外伤性颅内血肿503例,术后并发非手术区延迟性颅内血肿5例。约占全部手术病例1%。早期诊断和及时再次手术,可能有益于这些病人的预后。1 临床资料例1男,40岁。坠落致右颞顶伤,伤后2h入院。昏迷,右瞳>左瞳。头CT示:右颞顶骨折、硬膜外血肿,左额脑挫裂伤。即手术清除血肿。术中见硬脑膜张力高,脑搏动不明显,左瞳>右瞳。即再行对侧探颅硬膜下血肿清除术。术后病人恢复良好。例2男,39岁。车祸致右颞顶伤,伤后1h入院。昏迷,双瞳等大,右侧肢体偏瘫。头CT示:右颞顶骨折、左颞顶硬膜下血肿、左颞顶脑挫裂伤。即手术清除血肿。术中见脑膨胀明显,右瞳>左瞳,即再行对侧探颅硬膜外血肿清除术。术后病人好转。
Delayed intracranial hematomas (Delayed intracranial hematomas, DTICH) after craniotomy combined with craniocerebral trauma are the types of intracranial hematoma after delayed traumatic injury. It is different from surgical intracranial hemorrhage. The hospital from October 1985 to October 1995 surgically treated 503 cases of traumatic intracranial hematoma, postoperative non-operative complicated with delayed intracranial hematoma in 5 cases. About 1% of all cases of surgery. Early diagnosis and timely reoperation may benefit the prognosis of these patients. 1 clinical data example 1 male, 40 years old. Fall to the right temporal roof injury, 2h after admission. Coma, right pupil> left pupil. Head CT showed: right temporal top fracture, epidural hematoma, left frontal cerebral contusion. That surgery to remove the hematoma. See intraoperative dural tension is high, not obvious cerebral beats, left pupil> right pupil. That is, then the contralateral skull subdural hematoma removal. After the patient recovered well. Example 2 male, 39 years old. Car accident caused by right temporal crown injury, 1h after admission. Coma, double pupil and other large, right hemiplegia limbs. Head CT showed: right temporal top fractures, left temporal subdural hematoma, left temporal top cerebral contusion. That surgery to remove the hematoma. See intraoperative brain swelling obvious, right pupil> left pupil, that is, then the contralateral skull extracerebral hematoma removal surgery. Postoperative patients improved.