老年人慢性扩展性脑内血肿15例临床分析

Restrospective analysis of 15 cases of elderly chronic expending intracerebral hematoma

目的提高对老年人慢性扩展性脑内血肿的认识并探讨误诊原因。方法对15例老年人慢性扩展性脑内血肿患者的临床表现,头颅CT,MRI和组织学资料等进行回顾性分析。结果15例老年人慢性扩展性血肿临床表现呈多样性,误诊为脑膜瘤6例,胶质瘤7例,脑脓肿1例和脑囊虫病1例,误诊率100%。结论慢性扩展性脑内血肿在老年人中少见且容易造成误诊。影像学检查缺乏特征性表现及医师对该病认识不足是造成误诊的主要原因。

Objective To focus on understanding elderly chronic expending intracerebral hematoma and to discuss the reasons of its misdiagnosis in elderly patients with chronic expending intracerebral hematoma. Methods Clinical characters,radiological appearance （CT, MRI,DSA） and pathological examinations of 15 cases （≥60 years old） analyzed retrospectively. Results The elderly patients with chronic expending intracerebral hematoma patients manifested variously, with misdiagnosis rate being 100% .6 cases for meningioma,7 cases for glioma,one case for abscess of brain,one case were for cysticercosis of brain. All of cases had achieved excellent operative effect. 12 cases followed up from 6 months to 5 years had satisfactory living quality. Conclusions Chronic expending intracerebral hematoma among the elderly people is rarely seen and may be frequently misdiagnosed. Therefore, much more attention should be paid to it. The main reasons of misdiagnosis is the lack of radiological characters and poor understanding for elderly chronic expending intracerebral bematoma.