subacute epidural hematoma
Introduction
Introduction to subacute epidural hematoma Epidural hematoma with clinical signs and symptoms within 4 days to 3 weeks of trauma is subacute epidural hematoma. The incidence of subacute epidural hematoma after CT application is significantly increased, but should be delayed epidural The concept of hematoma is combined for diagnosis. basic knowledge Proportion of disease: seen in patients with brain trauma and hypertension. The incidence of hypertension is 1-5%. Brain trauma varies according to the different incidence rates of the injured parts, with an average of 20-40%. Susceptible people: no special people Mode of infection: non-infectious Complications: skull base fracture cerebrospinal fluid leakage pseudoaneurysm
Cause
Subacute epidural hematoma
Trauma violence (35%):
When the epidural is subjected to light traumatic violence, there is a cerebrospinal fluid leakage in the skull base fracture. Because the intracranial pressure is significantly lower than normal, the hematoma becomes larger and subacute epidural hematoma is formed. The middle meningeal artery and its branches are false due to trauma. Aneurysm rupture is also one of the possible causes of subacute epidural hematoma formation.
Partial mild oozing (25%):
Slightly linear fracture at the point of trauma, causing local oozing, gradually forming a hematoma; no fractures, slight deformation of the skull at the moment of injury, and rapid recovery after its elasticity, but has caused the skull and dura to peel off, making the inner surface of the skull With microvascular damage on the surface of the dura mater, hematoma is formed and gradually enlarged. Due to the slow formation of hematoma, intracranial pressure can be compensated by reducing the amount of cerebrospinal fluid secretion and reducing the total blood circulation in the brain. The clinical symptoms appear relatively slow and relative. Lighter.
Subacute epidural hematoma (30%):
Subacute epidural hematoma is a blood clot in the early stage. It usually appears on the 6th to 9th day, and gradually forms a layer of granulation tissue on the dura surface. The calcification of the hematoma is a sign of chronic hematoma, a large hematoma. CT can show its envelope and its central liquefaction.
Prevention
Subacute epidural hematoma prevention
Pay attention to living habits, prevent the occurrence of diseases in a timely manner, and promptly find timely treatment for diseases.
Complication
Subacute epidural hematoma complications Complications Skull base fracture cerebrospinal fluid leakage pseudoaneurysm
It may be complicated by a skull base fracture, a cerebrospinal fluid leak, or a pseudoaneurysm of the middle meningeal artery and its branches.
Symptom
Subacute epidural hematoma symptoms Common symptoms Nausea and vomiting dizziness consciousness disorder Increased intracranial pressure
The disease is more common in young men and young adults. Because they are engaged in production labor and other outdoor activities, and there is no connection between the dura mater and the skull, children and the elderly are close, and they occur in the forehead, top, posterior and occipital areas, because of the intracranial The increase in pressure is slow, and the chronic increase in intracranial pressure can occur for a long time. Headache, dizziness, nausea, vomiting, etc. are gradually worsened. Delayed diagnosis and treatment may cause disturbance of consciousness, hemiplegia, and aphasia.
Examine
Subacute epidural hematoma examination
1. CT scan: the performance is slightly higher, the same or low-density area is fusiform, enhanced CT scan can have the enhancement of the inner edge of the hematoma, which is helpful for the diagnosis of isodose hematoma.
2. MRI: Epidural hematoma was high in both T1 and T2 weighted images in the subacute and chronic phases.
Diagnosis
Diagnosis and diagnosis of subacute epidural hematoma
A clear history of trauma, X-ray plain film saw fractures, combined with clinical manifestations can make a preliminary diagnosis, individual history of trauma is not clear with chronic subdural hematoma and other intracranial space-occupying lesions, timely CT, MRI can be diagnosed.
Need to distinguish from acute epidural hematoma, chronic subdural hematoma and other intracranial space-occupying lesions, according to the onset time and clinical manifestations and impact performance can be identified.
