硬膜外血肿(EDH),也被称为硬膜外血肿,是内部颅骨台和硬脑膜之间的血液。它受到日冕的限制,lambdoid,和矢状缝线,因为这些是硬脑膜插入。EDH最常见于10至40岁的患者。EDH在60岁以后并不常见,因为硬脑膜物质牢固地粘附在内部颅骨台上。与女性相比,EDH在男性中更常见。EDH最常见于颞额叶区域,也可见于顶枕,矢状旁区,中后窝.EDH约占总头部损伤的2%,占总致命头部损伤的15%。在EDH,患者通常有持续的,严重头痛,而且,在几个小时的受伤之后,他们逐渐失去意识。EDH的主要出血血管是脑膜中动脉,脑膜中静脉,和硬膜静脉窦撕裂。EDH是可能导致死亡的严重创伤性脑损伤的众多后果之一。EDH可能是一种致命的疾病,需要立即干预,如果不及时治疗,它可以导致生长的经幕疝,意识减弱,扩大的瞳孔,和其他神经问题。非对比计算机断层扫描(NCCT)成像是诊断EDH的研究金标准。对于有手术指征的患者,早期开颅手术和急性硬膜外血肿清除术(AEDH)是金标准手术,预计将有显著的临床效果。然而,关于AEDH的最佳外科手术正在进行辩论。神经外科医生必须选择去骨瓣减压术(DC)或开颅手术来管理EDH,尤其是格拉斯哥昏迷评分较低的患者,有较好的预后和临床效果。这是一篇基于顾问的评论文章,我们试图考虑各种可用文献。这里,目的是假设DC是大量血肿的主要外科治疗方法,通常表现为格拉斯哥昏迷得分低。这是因为发现DC在临床实践中是有益的。
An extradural hematoma (EDH), also known as an epidural hematoma, is a collection of blood between the inner skull table and the dura mater. It is restricted by the coronal, lambdoid, and sagittal sutures, as these are dural insertions. EDH most frequently occurs in 10- to 40-year-old patients. EDH is uncommon after age 60, as dura matter adheres firmly to the inner skull table. EDH is more common among men as compared to women. EDH most commonly occurs in the temporo-frontal regions and can also be seen in the parieto-occipital, parasagittal regions, and middle and posterior fossae. An EDH contributes approximately 2% of total head injuries and 15% of total fatal head injuries. In EDH, patients typically have a persistent, severe headache, and also, following a few hours of injury, they gradually lose consciousness. The primary bleeding vessels for EDH are the middle meningeal artery, middle meningeal vein, and torn dural venous sinuses. EDH is one of the many consequences of severe traumatic brain injuries that might lead to death. EDH is potentially a lethal condition that requires immediate intervention as, if left untreated, it can lead to growing transtentorial herniation, diminished consciousness, dilated pupils, and other neurological problems. Non-contrast computed tomography (NCCT) imaging is the gold standard of investigation for diagnosing EDH. For patients with surgical indications, early
craniotomy and evacuation of acute extradural hematoma (AEDH) is the gold standard procedure and is predicted to have significant clinical results. Nevertheless, there is an ongoing debate regarding the best surgical operations for AEDH. Neurosurgeons must choose between a decompressive craniectomy (DC) or a
craniotomy to manage EDH, especially in patients with low Glasgow coma scores, to have a better prognosis and clinical results. This is a consultant-based review article in which we have tried to contemplate various pieces of available literature. Here, the objective is to hypothesize DC as the primary surgical management for massive hematoma, which usually presents as a low Glasgow coma score. This is because DC was found to be beneficial in clinical practice.