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目的总结创伤性双侧跨横窦硬脑膜外血肿(EDH)的临床特点和早期诊治方法。方法对11例双侧跨横窦EDH的临床特点、影像学检查结果、治疗方法和结果进行回顾性总结。结果11例中,2例伤后首次CT确诊,9例表现为进展性,经再次CT扫描确诊。手术治疗10例,保守治疗1例。10例发现枕骨跨横窦骨折。静脉性出血4例,静脉性和动脉性出血6例,不能确认1例。根据GOS评分,出院时恢复良好9例、中残1例、死亡1例。结论创伤性双侧跨横窦硬脑膜外血肿多表现为进展性,以动静脉混合性出血为主。早期确诊和处理可获得良好疗效。
Objective To summarize the clinical features and early diagnosis and treatment of traumatic bilateral transdiaphragmatic dural hematoma (EDH). Methods 11 cases of bilateral transverse transversal sinus EDH clinical features, imaging findings, treatment methods and results were retrospectively summarized. Results Of the 11 cases, 2 cases were diagnosed by CT for the first time after injury and 9 cases were progressive. CT scan confirmed by CT scan again. Surgical treatment in 10 cases, conservative treatment in 1 case. 10 cases of occipital transversal sinus fracture found. 4 cases of venous bleeding, venous and arterial bleeding in 6 cases, can not confirm in 1 case. According to the GOS score, nine patients recovered well, one was disabled and one died. Conclusion Traumatic bilateral transdiaphragmatic extradural hematoma is more progressive, with mixed arteriovenous bleeding. Early diagnosis and treatment can get good results.