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目的探讨反复头颅CT检查诊断迟发性硬膜外血肿的重要性及其检查指征。方法回顾性总结7例发生迟发性硬膜外血肿的颅脑外伤患者的病情发展及头颅CT检查情况。结果7例颅脑外伤患者均有明显的迟发性精神行为改变,发生时间为伤后4～52 h,CT复查均发现了迟发的硬膜外血肿。有5例患者出现了颅骨骨折,5例患者有顽固的剧烈头痛,恶心、呕吐加重患者3例,偏侧瞳孔扩大患者2例。意识障碍及抽搐患者各1例。结论颅脑外伤患者即使首次头颅CT扫描正常或轻度异常,若有颅骨骨折和(或)精神行为改变时,应复查CT以及时发现迟发性的硬膜外血肿。
Objective To investigate the importance of repeated head CT examination in the diagnosis of delayed epidural hematoma and its indications. Methods The clinical manifestations and head CT findings of 7 patients with traumatic brain injury with delayed epidural hematoma were retrospectively reviewed. Results All of the 7 traumatic brain injury patients had obvious delayed mental behavior, which occurred 4 ~ 52 h after trauma. Late epidural hematoma was found on CT examination. 5 patients had skull fracture, 5 patients had stubborn severe headache, nausea, vomiting aggravated in 3 patients, 2 patients with lateral dilation. 1 patient with disturbance of consciousness and convulsion. Conclusion Although craniocerebral trauma patients have normal or mild abnormality of the first cranial CT scan, if there is a change of skull fractures and / or mental behaviors, the CT should be reviewed and the delayed epidural hematoma should be found.