错过了诊断;成人非外伤性斜坡后血肿,简要报告及文献中类似病例的回顾与评价。

Ali Rıza Güvercin, Mehmet Aktoklu, Mehmet Orbay Bıyık, Uğur Yazar
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摘要

斜坡后硬膜下血肿(RSH)是一种罕见的现象,占急性轴外血肿的0.3%。虽然通常与创伤有关,但非创伤性原因包括凝血功能障碍、垂体中风和血管异常。由于非创伤性原因导致的病例的存在可以提出重大的诊断挑战。本文旨在通过回顾文献并介绍一位74岁妇女使用抗凝剂的病例研究,阐明非创伤性RSH的复杂性。主要目的是提高我们对这种疾病的诊断和治疗的理解,强调出血部位的重要性,特别是在计算机断层扫描(CT)扫描中,创伤除外。对文献的全面回顾揭示了28例成人非创伤性RSH。对这些病例的人口学特征、原因、表现和结果进行了详细分析。患者平均年龄59岁,男性略占优势,占57.57%。主要病因为垂体性中风(39.28%)和抗凝剂(21.42%),另有25%的病例病因不明。10.71%的病例发生椎管延伸,增加了发病率。回收率为92.85%,死亡率为3.57%。非创伤性RSH在标准影像学上未被充分认识和经常遗漏。保守治疗不压迫脊髓是有效的。意识是非常重要的,尤其是在诊断和治疗方面。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Missed diagnosis; non-traumatic retroclival haematoma in adults, brief case report with review and evaluation of similar cases in the literature.

Retroclival subdural haematomas (RSH) are a rare occurrence, accounting for 0.3% of acute extra-axial haematomas. Although typically associated with trauma, non-traumatic causes include coagulopathy, pituitary apoplexy and vascular anomalies.The presence of cases due to non-traumatic causes can present significant diagnostic challenges. This article aims to shed light on the intricacies of non-traumatic RSH by conducting a review of the literature and presenting a case study of a 74-year-old woman on anticoagulants. The primary objective is to enhance our understanding of the diagnosis and treatment of this condition, emphasising the significance of bleeding in a location that often goes unnoticed, particularly in Computed Tomography (CT) scans, with the exception of trauma. A comprehensive review of the literature revealed 28 cases of non-traumatic RSH in adults. A detailed analysis was conducted on the demographic characteristics, causes, presentations and outcomes of these cases.The mean patient age was found to be 59 years, with a slight male predominance of 57.57%. The primary causes were identified as pituitary apoplexy (39.28%) and anticoagulants (21.42%), while 25% of cases had an unknown aetiology. Spinal canal extension occurred in 10.71% of cases, which increased morbidity.The recovery rate was 92.85% and the mortality rate was 3.57%.Non-traumatic RSH is under-recognised and often missed on standard imaging.Conservative treatment is effective without spinal cord compression.Awareness is very important, especially for diagnosis and treatment.

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