目的：探讨外伤性后颅窝血肿的诊断、治疗及预后。方法对25例外伤性后颅窝血肿患者临床资料进行回顾性分析。结果首次头颅CT示后颅窝硬膜外血肿16例，硬膜下血肿4例，小脑挫裂伤并颅内血肿1例，复查发现进展性后颅窝硬膜外血肿4例。血肿位于单侧后颅窝22例，位于双侧后颅窝3例，血肿骑跨横窦2例，合并颅骨骨折10例，人字缝分离3例，合并幕上血肿4例。血肿致梗阻性脑积水形成5例，第四脑室、环池受压变形4例。12例行保守治疗，13例行手术治疗，术后死亡1例。伤后6个月，24例患者预后按GOS分级：2分1例；3分4例；4分10例；5分9例。保守治疗患者与手术患者平均预后分级评分无统计学差异。结论外伤性后颅窝血肿病情危重，早期诊断和治疗是改善患者预后的关键。%Objective To explore clinical characteristics of patients with traumatic hematomas of the posterior cranial fossa. Methods The clinical data of 25 patients with traumatic hematomas of the posterior cranial fossa were analyzed retrospectively. Results 16 cases of posterior fossa epidural hematoma, 4 cases of subdural hematoma and 1 case of cerebellar contusion and in-tracranial hematoma was found by first head CT image. The progressivity fossa epidural hematoma was found by repeat head CT image. 12 cases underwent conservative treatment, 13 cases underwent surgical treatment, 1 case died after operation.6 months af-ter injury, the prognosis of patients according to GOS classification:2 points in 1 case;3 points in 4 cases;4 points in 10 cases;5 points in 9 cases. The average prognosis score between patients with conservative treatment and operation has not significant dif-ference. Conclusion The prognosis of patients with traumatic hematomas of the posterior cranial fossa was poor. It ’s the key to improve prognosis by early diagnosis and treatment.
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