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題名 | Vacuum Extraction Delivery Complicated with Acute Subdural Hematoma and Cerebral Infarction:Report of One Case=真空吸引造成急性硬腦膜下出血併發腦梗塞:一病例報告 |
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作 者 | 劉慧燕; 黃立同; 呂鎮中; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 39:2 民87.03-04 |
頁次 | 頁119-122+135 |
分類號 | 417.582 |
關鍵詞 | 硬腦膜下出血; 腦梗塞; 新生兒; 真空吸引; Subdural hematoma; Cerebral infarction; Neonate; Vacuum; |
語文 | 英文(English) |
中文摘要 | 新生兒硬腦膜下出血常併發於生產時的傷害。我們的病人是一個足月女嬰,生產 時有用真空吸引,出生時並無異狀,出生23小時之後發生抽筋,同時有前囟門突出及貧血 等症狀,經電腦斷層攝影檢查發現左側顳葉及右側額頂葉有硬腦膜下出血,病人在四天大時 接受手術除去約20毫升的血液,術後情況大致良好。術後五天的磁振攝影發現仍有殘餘血 塊在左側額顳葉及後顱窩。病人於四十五天大時再接受電腦斷層攝影檢查發現疑有兩側枕葉 腦梗塞;到四個月大時追蹤磁振血管攝影的確可見兩側後大腦動脈有血流受阻的現象。病人 臨床上已無抽筋的表現,亦無發育遲緩,但卻有頭圍過小的情況。將來尚須密切追蹤頭圍成 長及神經學的成熟與發展。 硬腦膜下出血在新生兒由真空吸引生產者並不常見,但於術後追蹤時發現併發腦梗塞者 卻極罕見,故提出報告。 |
英文摘要 | We present a term, 2950 gm female neonate who was delivered by vacuum extraction and subsequently developed convulsions 23 hours after birth. Acute subduralhematoma was rapidly diagnosed by computed tomographic brain scan and successfully removed. The patient had a smooth postoperative recovery but cerebral infarction was found during follow up imaging studies. Magnetic resonance angiography revealed poor visualization of bilateral posterior cerebral arteries. After a follow-up period of 4 months, the infant had normal neurological development except for mild microcephalus. We report the occurrence of cerebral infarction in an infant following evacuation of a subdural hematoma. Onset of the late complication suggests the importance of serial neuroradiological and clinical evaluations. |
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