【摘要】 目的:探讨老年外伤性硬膜下积液(TSE)演变成慢性硬膜下血肿(CSDH)的概率、发病机制、临床特点与治疗方法。方法:回顾性分析老年TSH演变成CSDH患者41例的演变过程、临床表现、治疗方法与结果。结果:本组老年TSH患者119例演变为CSDH 41例,其临床表现以头痛与偏瘫或肢体乏力为主。接受钻颅血肿引流术治疗35例,行开颅血肿清除手术2例。术后痊愈20例;残留少量硬膜下积液11例;复发6例,复发率16.2%。保守治疗患者无明显变化4例。结论:老年TSH是CSDH的来源之一,老年TSH患者应使用CT或MRI动态观察,以期早期发现CSDH。单孔钻颅闭式引流术治疗本病疗效确切。如果血肿腔有多分隔、血肿壁厚并有大量血凝块应行骨瓣开颅血肿清除术。更多还原

【Abstract】 Objective:To probe into the incidence,mechanism,clinical characteristics and treatment of chronic subdural hematoma(CSDH)evolving from traumatic subdural hygroma(TSH)in the elderly.Methods:The clinical manifestations,evolution process,treatment methods and results of 41 cases with CSDH evolving from TSH in the elderly were analyzed retrospectively.Results:A total of 41 TSH cases developed into CSDH in the elderly.The most common symptoms at that time were headache,hemiparesis or Limb weakness.35 cases were treated by burr hole irrigation and continuous closed-system drainage.2 cases were treated by craniotomy.CSDH disappeared in 20 patients,11 patients into a small subdural effusion,6 patients experienced recurrence of the CSDH,the recurrence rate was 16.2%.Conservative treatment showed no obvious change in 4 patients.Conclusions:TSH is one of the origins of CSDH in the elderly.The cases of TSH in the elderly should be dynamic viewed by CT or MRI and CSDH can be discoved early.The burr hole and drainage operation for chronic subdural hematoma is very effective.If there are multiple septum,thick-walled and a large blood clot in hematoma cavity,they will be treated by craniotomy.更多还原