硬脑膜外血肿

硬脑膜外血肿
硬脑膜外血肿
异名	Epidural hematoma, extradural hematoma, epidural hemorrhage, epidural haematoma, epidural bleeding
	计算机体层成像显示硬脑膜外血肿与血肿外的颅骨骨折。注意血肿呈现双凸形。大脑的另一侧也有瘀伤和出血。
症状	头痛、精神错乱、瘫痪
起病年龄	快速
病因	头部损伤, 凝血病, 血管崎形（英语：vascular malformation）
诊断方法	医学影像 (CT scan)
鉴别诊断	硬脑膜下血肿, 蛛网膜下腔出血, 创伤性脑损伤, 短暂性脑缺血发作癫痫发作, 脑脓肿（英语：Brain abscess）, 脑瘤
治疗	手术 (开颅手术, 头部穿孔手术)
分类和外部资源
医学专科	神经外科, 神经内科, 急诊医学
ICD-10	I62.1、S06.4
DiseasesDB	4353
MedlinePlus	001412
eMedicine	824029、248840、1137065
	[编辑此条目的维基数据]

硬脑膜外血肿（Epidural hematoma），简称硬膜外血肿，是指覆盖大脑的坚韧外膜（硬脑膜）之外与头骨之间的出血^[4]。头部受伤后，患者常常会失去意识（英语：Unconsciousness），短暂恢复意识，之后再次失去意识^[2]。其他症状包括可能头痛、精神错乱、呕吐以及无法移动身体的某个部位^[1]。并发症包括可能癫痫发作^[1]。

典型的病因是头部损伤，造成颞骨骨裂和中脑膜动脉（英语：Middle meningeal artery）出血^[4]。凝血病或血管崎形（英语：Vascular malformation）也可能是病因^[1]。通常透过计算机体层成像或磁共振成像等影像检查确定诊断^[1]。若类似的出血发生在脊柱时，就称为脊椎硬膜外血肿（英语：Spinal epidural hematoma）^[4]。

硬脑膜外血肿一般以开颅手术或钻孔手术等紧急手术治疗^[1]。文献中也曾提过利用植入骨内针来引流出血，达到减压的目地^[5]。若不治疗，通常会死亡^[6]。在头部损伤患者中约1% 到 4%会发生硬脑膜外血肿^[1]。通常发生在年轻人^[1]。男性较女性多^[1]。

参考文献

^ ^1.00 ^1.01 ^1.02 ^1.03 ^1.04 ^1.05 ^1.06 ^1.07 ^1.08 ^1.09 ^1.10 ^1.11 ^1.12 Ferri, Fred F. Ferri's Clinical Advisor 2017 E-Book: 5 Books in 1. Elsevier Health Sciences. 2016: 441 [2020-06-03]. ISBN 9780323448383. （原始内容存档于2021-08-28）（英语）.
^ ^2.0 ^2.1 Pooler, Charlotte. Porth Pathophysiology: Concepts of Altered Health States. Lippincott Williams & Wilkins. 2009: 1256 [2020-06-03]. ISBN 9781605477817. （原始内容存档于2021-08-29）（英语）.
^ Khairat, Ali; Waseem, Muhammad, Epidural Hematoma, StatPearls (StatPearls Publishing), 2018 [2019-02-13], PMID 30085524
^ ^4.0 ^4.1 ^4.2 Pryse-Phillips, William. Companion to Clinical Neurology. Oxford University Press. 6 May 2009: 335 [8 October 2014]. ISBN 9780199710041. （原始内容存档于23 April 2017）. Epidural hemorrhage (epidural hematoma, extradural hemorrhage, or hematoma) Bleeding outside the outermost layer of the dural mater, which is thus stripped away from the inner table of the skull or spinal canal.
^ Unlocking Common ED Procedures – Crackin’ the Cranium: A Review of Cranial Burr Hole Decompression. emDOCs.net - Emergency Medicine Education. 9 April 2020 [15 March 2021]. （原始内容存档于28 November 2020）（英语）.
^ Rubin, Raphael; Strayer, David S.; Rubin, Emanuel; (M.D.), Jay M. McDonald. Rubin's Pathology: Clinicopathologic Foundations of Medicine. Lippincott Williams & Wilkins. 2008: 1183 [2020-06-03]. ISBN 9780781795166. （原始内容存档于2021-08-28）（英语）.

外部链接

[Fer2017-1] 1.00 ^1.01 ^1.02 ^1.03 ^1.04 ^1.05 ^1.06 ^1.07 ^1.08 ^1.09 ^1.10 ^1.11 ^1.12 Ferri, Fred F. Ferri's Clinical Advisor 2017 E-Book: 5 Books in 1. Elsevier Health Sciences. 2016: 441 [2020-06-03]. ISBN 9780323448383. （原始内容存档于2021-08-28）（英语）.

[Po2009-2] 2.0 ^2.1 Pooler, Charlotte. Porth Pathophysiology: Concepts of Altered Health States. Lippincott Williams & Wilkins. 2009: 1256 [2020-06-03]. ISBN 9781605477817. （原始内容存档于2021-08-29）（英语）.

[Kha2018-3] Khairat, Ali; Waseem, Muhammad, Epidural Hematoma, StatPearls (StatPearls Publishing), 2018 [2019-02-13], PMID 30085524

[New2009-4] 4.0 ^4.1 ^4.2 Pryse-Phillips, William. Companion to Clinical Neurology. Oxford University Press. 6 May 2009: 335 [8 October 2014]. ISBN 9780199710041. （原始内容存档于23 April 2017）. Epidural hemorrhage (epidural hematoma, extradural hemorrhage, or hematoma) Bleeding outside the outermost layer of the dural mater, which is thus stripped away from the inner table of the skull or spinal canal.

[EMD2021-5] Unlocking Common ED Procedures – Crackin’ the Cranium: A Review of Cranial Burr Hole Decompression. emDOCs.net - Emergency Medicine Education. 9 April 2020 [15 March 2021]. （原始内容存档于28 November 2020）（英语）.

[6] Rubin, Raphael; Strayer, David S.; Rubin, Emanuel; (M.D.), Jay M. McDonald. Rubin's Pathology: Clinicopathologic Foundations of Medicine. Lippincott Williams & Wilkins. 2008: 1183 [2020-06-03]. ISBN 9780781795166. （原始内容存档于2021-08-28）（英语）.

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