122例外伤性急性硬膜下积液的CT诊断

目的：回深对外伤性急性硬膜下积液（ATSH）的认识和提高其早期确诊率。方法：回顾性分析122例ATSH的CT表现、演变过程及其转归情况。CT扫描均用轴位平扫。结果：本组ATSH122例186处，少量积液89例；迟发性积液145处；积液位于额颞部或（和）大脑镰旁前上部114例；复合性积液101例（合并蛛网膜下腔出血72例、脑挫裂伤61例）；103例经保守治疗痊愈，3例演变为慢性硬膜下血肿，5例经手术治愈；早期漏诊25例。结论：大脑镰旁前上部是ATSH的好发部位之一；少量的ATSH早期可漏诊，积液不在损伤相关的部位及扫描未包全额顶部层面是早期漏诊的主要原因。

CT diagnose of acute traumatic subdural hygroma

Aim: To raise definitive diagnostic rate in early stage of diagnosing acute traumatic subdural hygroma(ATSH) on CT and deepen recognition of the ATSH. Methods: CT manifestation, evalutional course and eventual result of 122 ATSH cases were analysed. Research was carried out retrospectively on axial section. Results: Among 122 ATSH cases with 186 focus, 89 cases had a small amount of accumulation fluid, 145 cases were delayed cases; 114 cases situated in the frontotemporal part and in the anterior part along the cerebral falx, 101 cases were complex fluid accumulation (72 cases complicated with SAH, 61 cases associate with cerebral contusion and laceration); 103 cases recovered by conservative treatment, 3 cases evolved into chronic subdural hematoma, 5 cases recovered by surgery; 25 cases were missed diagnosing in early stage. Conclusion: The antero-upper part alongside the cerebral falx is one of the preferential positon of ATSH. A small amount of ATSH can be missed diagnosing in early stage. Fluid accumulation, not in position correlated with the injury and scanning not including all frontoparietal levels are the main causes of missing diagnosis in early stage.