Abstract：
OBJECTIVE: To assess clinical and radiological characteristics of simultaneous acute supra- and infratentorial epidural hematomas.
METHODS: We retrospectively reviewed the clinical and radiological data of 18 patients with a concomitant acute supra- and infratentorial epidural hematoma, who were treated and followed up at our hospital.
RESULTS: The Glasgow Coma Score was 3-8 in four patients, was 9-12 in seven, and was 13-15 in seven patients. While the concomitant supra- and infratentorial hematoma did not cross the midline in 15 of the patients, it did in three of them. The dural venous sinus rupture was repaired in five of the patients. Functional healing was observed in 14 of the 18 patients. Two of the patients died during the postoperative period.
CONCLUSIONS: A simultaneous supra- and infratentorial epidural hematoma rarely occurs in neurosurgical practice. Mortality and morbidity rates are high if these are not addressed in time. The radiological images of patients should be evaluated carefully preoperatively. In patients with a concomitant infra- and supratentorial hematoma, transverse sinus damage, which is a surgical challenge, should be considered. Herein, we describe a surgical technique (supra- and infratentorial craniotomy leaving the bone bridge over the transverse sinus) for draining a concomitant supra- and infratentorial epidural hematoma; this technique is an effective surgical choice in select patients.
METHODS: We retrospectively reviewed the clinical and radiological data of 18 patients with a concomitant acute supra- and infratentorial epidural hematoma, who were treated and followed up at our hospital.
RESULTS: The Glasgow Coma Score was 3-8 in four patients, was 9-12 in seven, and was 13-15 in seven patients. While the concomitant supra- and infratentorial hematoma did not cross the midline in 15 of the patients, it did in three of them. The dural venous sinus rupture was repaired in five of the patients. Functional healing was observed in 14 of the 18 patients. Two of the patients died during the postoperative period.
CONCLUSIONS: A simultaneous supra- and infratentorial epidural hematoma rarely occurs in neurosurgical practice. Mortality and morbidity rates are high if these are not addressed in time. The radiological images of patients should be evaluated carefully preoperatively. In patients with a concomitant infra- and supratentorial hematoma, transverse sinus damage, which is a surgical challenge, should be considered. Herein, we describe a surgical technique (supra- and infratentorial craniotomy leaving the bone bridge over the transverse sinus) for draining a concomitant supra- and infratentorial epidural hematoma; this technique is an effective surgical choice in select patients.
摘要：
目的：同时发生急性上和下硬膜外血肿很少发生，文献报道有限。幕下血肿导致快速恶化和猝死，相关并发症比幕上血肿更显著，其特征可以掩盖幕下硬膜外血肿。
方法：我们回顾性回顾了18例伴有急性上和幕下硬膜外血肿的临床和影像学资料，他们在我们医院接受了治疗和随访。
结果：4例患者的格拉斯哥昏迷评分为3-8分，是9-12在7,7名患者为13-15。虽然15例患者中伴随的幕上血肿和幕下血肿没有越过中线，在其中三个人中做到了。其中五名患者修复了鼻窦破裂。18例患者中有14例观察到功能愈合。其中两名患者在术后死亡。
结论：在神经外科手术中很少同时发生幕上和幕下硬膜外血肿。如果不及时解决这些问题，死亡率和发病率很高。术前应仔细评估患者的放射学图像。在伴有幕下和幕上血肿的患者中，横窦损伤,这是一个手术挑战，应该考虑。在这里，我们描述了一种手术技术（上颅和下颅开颅术，将骨桥留在横窦上），用于引流伴随的上颅和下颅硬膜外血肿；该技术是特定患者的有效手术选择。
方法：我们回顾性回顾了18例伴有急性上和幕下硬膜外血肿的临床和影像学资料，他们在我们医院接受了治疗和随访。
结果：4例患者的格拉斯哥昏迷评分为3-8分，是9-12在7,7名患者为13-15。虽然15例患者中伴随的幕上血肿和幕下血肿没有越过中线，在其中三个人中做到了。其中五名患者修复了鼻窦破裂。18例患者中有14例观察到功能愈合。其中两名患者在术后死亡。
结论：在神经外科手术中很少同时发生幕上和幕下硬膜外血肿。如果不及时解决这些问题，死亡率和发病率很高。术前应仔细评估患者的放射学图像。在伴有幕下和幕上血肿的患者中，横窦损伤,这是一个手术挑战，应该考虑。在这里，我们描述了一种手术技术（上颅和下颅开颅术，将骨桥留在横窦上），用于引流伴随的上颅和下颅硬膜外血肿；该技术是特定患者的有效手术选择。
