経皮的骨膜下血腫吸引で消失した急性硬膜外血腫の1例

Rapid Disappearance of Acute Epidural Hematoma by Percutaneous Aspiration of Subperiosteal Hematoma―Case Report

はじめに

　硬膜外血腫は通常頭蓋骨骨折を伴い，緊急手術を要する場合がほとんどであるが，稀に血腫が消失する症例がある。われわれは骨折を伴った急性硬膜外血腫に対して，創処置時皮下血腫を除去することで硬膜外血腫の消失を促したと思われる症例を経験したので，文献的考察を加えて報告する。

Abstract

　We present the case of an 8-year-old boy who was injured in a bicycle accident and was admitted with a right frontal skull fracture, an acute epidural hematoma, a right frontal laceration, and a subperiosteal hematoma on admission.　After the frontal cutaneous suture, the subperiosteal hematoma was aspirated by the percutaneous needle.　Two hours later, a CT scan revealed that the epidural hematoma was disappeared.　It is speculated that the subperiosteal and epidural hematoma communicated via the skull fracture thus necessitating the evacuation of the epidural hematoma by subperiosteal aspiration.