[1]马超,朱昀,杨博宇,等.幕上脑肿瘤术后远隔性小脑出血临床分析[J].临床神经外科杂志,2019,16(6):549-552.[doi:10.3969/j.issn.1672-7770.2019.06.020]
 MA Chao,ZHU Yun,YANG Bo-yu,et al.Clinical analysis on cerebellar hemorrhage after supratentorial brain tumor resection[J].Journal of Clinical Neurosurgery,2019,16(6):549-552.[doi:10.3969/j.issn.1672-7770.2019.06.020]
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幕上脑肿瘤术后远隔性小脑出血临床分析()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年第6期
页码:
549-552
栏目:
临床研究
出版日期:
2019-12-10

文章信息/Info

Title:
Clinical analysis on cerebellar hemorrhage after supratentorial brain tumor resection
作者:
马超朱昀杨博宇王中
215006 苏州,苏州大学附属第一医院神经外科
Author(s):
MA Chao ZHU Yun YANG Bo-yu et al.
Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
关键词:
远隔性小脑出血小脑出血幕上开颅术并发症
Keywords:
remote cerebellar hemorrhage cerebellar hemorrhage supratentorial craniotomy complication
分类号:
R739.41
DOI:
10.3969/j.issn.1672-7770.2019.06.020
文献标志码:
D
摘要:
【摘要】目的探讨颅内幕上脑肿瘤切除术后远隔性小脑出血的临床表现、治疗、预后及发生机制。方法回顾性分析3例幕上脑肿瘤切除术后远隔性小脑出血患者的临床资料。并结合文献复习,分析其临床表现、治疗方案、预后。结果3例患者均表现为头痛、呕吐,其中2例患者表现进行性意识障碍。CT检查发现远隔性小脑出血发生于双侧2例,单侧1例。1例患者行后颅窝去骨瓣减压术,1例患者行小脑血肿清除术+幕上/后颅窝去骨瓣减压术,1例患者采用对症治疗后出血完全吸收。1例患者术后10 d死亡;另外2例患者出院后随访3~6个月,格拉斯哥预后量表(GOS)评分5分者1例,3分1例。结论头痛、呕吐及进行性意识障碍是幕上脑肿瘤切除术后远隔性小脑出血常见临床表现,术后早期CT检查有助于早期诊断;积极的早期治疗可明显降低患者病死、病残率,改善预后。术中及术后脑脊液流失导致颅内压急剧改变可能是其发生的机制。
Abstract:
Abstract: ObjectiveTo investigate the remote cerebellar hemorrhage(RCH) after surgery for supratentorial clinical manifestations, treatment, prognosis and mechanism of hemorrhage. MethodsThe clinical data of 3 patients with RCH after supratentorial craniotomy were analyzed retrospectively . Results 3 patients presented with headache and vomiting after surgery, 2 of them presented with progressive consciousness decreasing. Postoperative CT examination revealed that RCH occurred bilaterally in 2 cases and unilateral in 1. Of 3 cases,1 received posterior fossa decompression, 1 received hematoma removal and supratentorial/posterior fossa decompression, and 1 recovered after symptomatic treatment. The follow-up period ranged from 0 to 6 months. The Glasgow Prognosis Score (GOS) was grade Ⅴ in 1 case, grade Ⅲ in 1 and grade Ⅰ in 1. ConclusionsRCH after supratentorial craniotomy is rare. Early post-operative CT examination is helpful for early diagnosis, close monitoring, active hematoma clearance and posterior fossa decompression can significantly reduce the mortality, disability rate and improve the prognosis of patients. Intracranial pressure drops sharply during and after operation due to a large amount of cerebrospinal fluid loss which may be the mechanism.

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[1]王志明,殷尚炯,王阳春,等.持续颅内压监测在小脑出血手术中的应用(附16例报告)[J].临床神经外科杂志,2014,(01):72.
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更新日期/Last Update: 2019-12-10