受傷後早期に吸収された乳児急性硬膜外血腫の1例

Rapid Spontaneous Resolution of Acute Epidural Hematoma in an Infant:A Case Report

Ⅰ．はじめに

　神経症状を伴わない急性硬膜外血腫に対しては保存的治療が選択される場合が多いが，血腫が吸収され消失するまでは数週間単位での期間を要する．今回われわれは骨折部を介して血腫が頭蓋外へ移動し，早期に消失したと考えられた稀な急性硬膜外血腫の乳児例を経験したので，その機序と小児期の急性硬膜外血腫の治療方針に関し文献的考察を交えて報告する．

　Resolution of acute epidural hematoma（AEDH）usually takes several weeks. The authors present an infantile case of AEDH that rapidly decreased within a day and review the literature.

　A 7-month-old boy fell from a height of approximately one meter and sustained a head injury. On presentation, a skull fracture in the right temporoparietal region was found and a small AEDH was observed on computed tomography（CT）1hr after the injury. He was transferred to our institute because of growing AEDH, shown by CT images taken 3hr after the injury. We decided to treat him conservatively as he did not exhibit any neurological deficits on admission. CT images 24hr after the injury showed significant reduction of the AEDH. There was also an increase in the subcutaneous hematoma. Follow-up CT images did not show enlargement of the AEDH. The patient was discharged with no neurological deficits 3 days after admission. Rapid resolution of the AEDH might have been due to transmigration of the hematoma into the epicranial layer through the fracture gap.