老年慢性硬膜下血肿的病因、临床特征和影响预后因素

Analysis of the etiology,cliical features and affecting factors on prognosis

目的探索老年慢性硬膜下血肿的病因、临床特征和影响预后因素分析。方法回顾性分析58例60岁以上的老年慢性硬膜下血肿患者的临床表现和影像学特点及影响预后因素。结果以精神症状和偏瘫来院就诊者42例,表现为头痛、呕吐者18例。39例经一次钻孔引流手术,血肿消失;5例患者需二次钻孔引流;3例患者需三次手术。结论老年慢性硬膜下血肿可以表现为精神症状和偏瘫,易误诊为老年痴呆和脑血管疾病,CT扫描是鉴别的最好手段。一旦确诊应尽早手术。

Objective To explore the etiology, clinical features and prognostic affecting factors of the elderly with chronic subdural hernatoma. Methods Clinical manifestations ,imaging features and prognostic factors of 58 patients over 60 years old with chronic subdural hematoma were retrospectively analyzed. Results Forty-two patients with mental symptoms and paralysis as the origin went to hospital, eighteen patients showed headache and vomiting. Thirty-nine cases hernatoma disappeared by first surgical drainage hole; Five patients required secondary surgical drainage hole; Three patients required the third surgical drainage hole. Conclusion The elderly with chronic subdural hematoma can be expressed as psychiatric symptoms and paralysis,and is often misdiagnosed as Alzheimer＇s disease and cerehrovascular disease. CT scan is the best means of identification. Surgery should be given as soon as possible once be diagnosed.