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A life threatening problem in infants: supratentorial epidural hematoma

机译:婴幼儿威胁生命的问题:硬膜上硬膜外血肿

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摘要

Traumatic epidural hematoma (EDH) represents a rare head injury complication in infants.Its diagnosis can be quite challenging because its clinical presentation is usually subtle and nonspecific.Authors present a study on 30 infants with epidural hematoma (EDH) admitted in the Pediatric Department of Neurosurgery of the ‘Bagdasar–Arseni’ Clinical Hospital in the period of 1990–2007 (17 years).The most common symptom was irritability, which occurred in 16 cases (53.3%), of our patients. Pallor in all cases (100%) and subgaleal hematoma in 20/30 (66.6%) of the patients. These were the most common clinical signs that occurred upon admission; both of them represent signs of significant clinical importance. Surgical evacuation via craniotomy was required in 26/30 (86.6%) of our patients, while 4/30 (13.3%) of the patients were managed conservatively. The mortality rate was 6.6% in our series, whilst the long–term morbidity rate was 3.3%.EDH in infants represents a life–threatening complication of head injury, which requires early identification and prompt surgical or conservative management depending on the patient's clinical condition, the size of EDH, and the presence of a midline structure shift on the head's CT scan.
机译:外伤性硬膜外血肿(EDH)在婴儿中是一种罕见的颅脑外伤并发症,由于其临床表现通常是微妙的且非特异性的,因此其诊断可能非常具有挑战性。作者介绍了一项针对30例硬膜外血肿(EDH)婴儿入院的研究。 1990-2007年(17年),在“ Bagdasar–Arseni”临床医院进行了神经外科手术。最常见的症状是易怒,在我们的患者中发生了16例(53.3%)。在所有情况下均为苍白(100%),在20/30(66.6%)的患者中有睑下血肿。这些是入院时最常见的临床症状。它们都代表着重要的临床意义。我们有26/30(86.6%)的患者需要通过开颅手术进行手术疏散,而其中有4/30(13.3%)的患者需要保守治疗。在我们的系列中,死亡率为6.6%,而长期发病率为3.3%。婴儿EDH代表危及生命的颅脑损伤并发症,需要根据患者的临床状况及早发现并及时进行手术或保守治疗,EDH的大小以及头部CT扫描中线结构的变化。

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