自发性硬膜下血肿的临床及CT分析

Analysis of CT and clinic of the spontaneous subdural hematoma

目的：分析自发性硬膜下血肿的临床和CT表现特点，提高本病的认识。方法：回顾分析16例自发性硬膜下血肿的CT和临床资料。结果：CT表现：血肿多位于大脑突面，多累及2—3个部位。急性期4例，亚急性期6例，慢性期6例，均表现为颅内板下弧形，“3”字形，新月状不同密度影，最大血肿厚度大于10mm有8例，不同程度的脑中线移位。临床表现：除1例快速进入昏迷外，其余早期表现为头痛、头晕，恶心、呕吐，易疲劳，智力衰退、模糊，继而出现偏瘫，意识障碍，昏迷等．11例经内科保守治疗和4例外科手术治疗患者症状明显好转和痊愈。结论：自发性硬膜下血肿多见于老年人，CT表现以亚急性期和慢性期多见，且出血量大而范围广，脑中线移位明显。临床起病隐袭，早期临床表现无特异性，症状加重时往往出血量大，早期易延误诊断，及时治疗临床效果好。

Objective： To analyze features of CT and clinic manifestation. Methods： CT findings and clinical data of 16 cases with spontaneous subdural hematoma were retrospectively analyzed. Results： Of 16 cases, males 9, females 7, age 63 - 84, the average 73 years. CT finding： acute period 4, suhacute period 6,chrenic period 6, the lesions were arched or ＂3＂word or crescent with high-density or isodense or low-dense at sub-inner layer of cranium, the thickness of the hematoma 〉 10mm 8 cases, midline of brain displaced obviously. The clinical appearances： besides 1 case, the other 15 cases had headache, dizzy, nausea, vomiting, defatigation, intelligence dementia, ambiguity, later appeared： conscious disturbance, coma etc. 11 cases were treated medicaliy and 4 cases were treated surgically. Conclusion：The spontaneous hematomas are often in old patients, CT features： suhacute and chronic periods were much, the blooding volume were large and wide, the displacing of cerebral were obviously. Clinic features： clinic were insidious onset, early clinical appearance were not specificity, the blood volume were large and wide, while symptom increased, the earlier period was misdiagnesis easily, the clinical result treated was well in time.