Травматические повреждения задней черепной ямки у детей
https://doi.org/10.17650/1683-3295-2012-12-1-32-40
Abstract
Authors present 22 patients with traumatic injuries of posterior cranial fossa (PCF). Frequency of PCF injury was amount to 0,076% of all patients with head injury treated in Moscow City Clinical Hospital for Children. Hemorrhage into PCF was revealed at 16 patients among them 12 children had epidural hematoma, 1 – subdural and intracerebral hematomas, 3 – intracerebral hematoma. Hematoma evacuation was performed at 9 patients, 2 children underwent implantation of external ventricular drainage (EVD). Among all 6 patients with depressed fractures of occipital bone 5 children underwent surgical treatment – reposition of bone fragments. Indications for surgical treatment because of PCF hematomas and cerebellum contusions were hematoma volume exceeding 18 cm3, cerebellum lesions with the volume more than 17 cm3, cisterns narrowing as well as presence of common and focal neurological signs. Expectant management at children with PCF injuries is possible for epidural hematoma with the volume not exceeding 9–18 cm3, cerebellum lesions with the volume not more than 13–17 cm3, as well as in the case of occlusive hydrocephaly and focal neurological signs absence. Conservative treatment at children with PCF injuries was conducted in the case of epidural hematoma less than 9 cm3, cerebellum lesions with the volume till 13 cm3. 20 patients were fully recovered, one patient had moderate disability. One patient has died
About the Authors
В.Е. Попов
Морозовская детская городская клиническая больница, Москва
Russian Federation
Russian Federation
А.Б. Карпов
Морозовская детская городская клиническая больница, Москва
Russian Federation
Russian Federation
М.И. Лившиц
Морозовская детская городская клиническая больница, Москва
Russian Federation
Russian Federation
В.Н. Умеренков
Морозовская детская городская клиническая больница, Москва
Russian Federation
Russian Federation
Е.В. Андреева
Морозовская детская городская клиническая больница, Москва
Russian Federation
Russian Federation
П.И. Манжос
Морозовская детская городская клиническая больница, Москва
Russian Federation
Russian Federation
М.Ж. Чигибаев
Морозовская детская городская клиническая больница, Москва
Russian Federation
Russian Federation
О.А. Меркулов
Морозовская детская городская клиническая больница, Москва
Russian Federation
Russian Federation
А.В. Горбунов
Морозовская детская городская клиническая больница, Москва
Russian Federation
Russian Federation
References
1. Артарян А.А. Черепно-мозговая травма у детей / Нейротравматология. Под редакцией Коновалова А.Н., Лихтермана Л.Б., Потапова А.А. – М., 1994 – С. 209–214.
2. Банин А.В. Черепно-мозговая травма средней и тяжелой степени у детей: (Клиника, диагностика, лечение, исхо- ды). Автореф. дис. д-ра мед. наук. – М., 1993. – 42 с.
3. Крылов В.В., Талыпов В.В., Ткачев В.В. Повреждения задней черепной ямки. – М.: Медицина, 2005.
4. Лихтерман Л.Б., Хитрин Л.Х. Травматические внутричерепные гематомы. – М.: Медицина, 1973.
5. Ahmet Çolak, Mustafa Berker and Osman Ekin Özcan: Occipital depression fractures in childhood. A report of 14 cases. Child’s Nervous System 1991 Vol. 7, Number 2, р. 103-105.
6. Ammirati M., Tomita T.: Posterior fossa epidural hematoma during childhood. Neurosurgery 1984; 14: 541–44.
7. Ateș Ö., Koçak A., Önal Ç., Tar m Ö., Çayl S., Tektaș Ș.: Travmatik posterior fossa hematomlar . Ïnönü Üniversitesi Tıp Fakültesi Dergisi 2002; 9: 205 – 9.
8. Bezircioglu H., Ersahin Y., Demircivi F., Yurt I., Donertas K., Tektas S.: Nonoperative treatment of acute extradural hematomas: analysis of 80 cases. J. Trauma 1996;41:696-8.
9. Bor-Seng-Shu E, Aguiar PH, Matushita H., Manreza LA, Ferreira AA: Actual asymptomatic epidural hematomas in childhood. Report of three cases. Childs Nerv. Syst. 1997;13: 605–7.
10. Bor-Seng-Shu E, Aguıar PH., Leme RJDA, Mandel M., Andrade AFD, Marın RJR: Epidural hematomas of the posterior cranial fossa. Neurosurg. Focus 2004; 16: 1– 4.
11. Bozbuga M., Izgi N., Polat G., Gürel I.: Posterior fossa epidural hematomas: observations on a series of 73 cases. Neurosurg. Rev. 1999; 22: 34–40.
12. Ciurea A.V., Nuteanu L., Simionescu N., Georgescu S. Posterior fossa extradural hematomas in children: report of nine cases. // Childs Nervous System. 1993. – Vol.9, — N4, — P. 224-228.
13. Chen TY, Wong CW, Chang CN, Lui TN, Cheng WC, Tsai MD, Lin TK 1993 The expectant treatment of “asymptomatic” supratentorial epidural hematomas. Neurosurgery 32: 176-179.
14. Choux M., Grisoli F., Peragut JC. Extradural haematomas in children: 104 cases. Child’s Brain 1975; 1: 33 7-347.
15. Dalgic A., Secer M., Ergüngör M.F., Okay H.O., Uckun Ö., Yildirim A.E. Traumatic Posterior Fossa Epidural Hematomas and Their Complications Journal of Neurological Sciences (Turkish) 2007, Volume 24, Number 4, Page(s) 280-286.
16. Ersahin Y., Mutluer S. Posterior fossa extradural hematomas in children. Pediatr. Neurosurg. 1993; 19: 31–33 .
17. Hooper R.S.: Extradural haemorrhages of the posterior fossa. Br. J. Surg. 42:19–26, 1954.
18. Gallagher JP, Browder EJ. Extradural hematoma: experience with 167 patients. J Neurosurg 1968; 29: 1-12.
19. Kawakami Y.; Tamiya T.; Tanimoto T.; Shimamura Y.; Hattori S.; Ueda T.; Ishida T. Nonsurgical treatment of posterior fossa epidural hematoma. Pediatr. Neurol. 1990 Mar-Apr; 6(2): 112-8.
20. Karasawa H., Furuya H., Naito H., Sugiyama K., Ueno J., Kin H. // Acute Hydrocephalus in posterior fossa injury. J. Neurosurgery. – 1997, - Vol. 86, N 4, P. 629-632.
21. Knuckey N., Gelbard S., Epstein MH (1989) The management of “asymptomatic” epidural hematomas. A prospective study. J. Neurosurg 70:392–396.
22. Lee EJ, Hung YC, Wang LC, Chung KC, Chen HH: Factors Influencing the Functional Outcome of Patients with Acute Epidural Hematomas: Analysis of 200 Patients Undergoing Surgery. J. Trauma 1998; 45: 946-52.
23. McLaurin R., Towbin R. (1989) Posttraumatic hematomas. In: McLaurin R., Schult L., Veres J., Epstein F. (eds) Pediatric neurosurgery, 2nd edn. Saunders, Philadelphia, pp. 277–289.
24. Pang D., Horton JA, Herron JM, Wilberger JE Jr., Vries JK (1983) Nonsurgical management of extradural hematomas in children. J. Neurosurg 59: 958–971.
25. Zuccarello M., Andrioli G. C., Fiore D. L., Longatti P. L., Pardatscher K., Zampieri P. Traumatic posterior fossa haemorrhage in children Acta Neurochirurgica Volume 62, Numbers 1-2 / 1982, p. 79-85.
Review
For citations:
, , , , , , , , . Russian journal of neurosurgery. 2012;12(1):32-40. (In Russ.) https://doi.org/10.17650/1683-3295-2012-12-1-32-40
Views:
543
Email this article 