慢性硬膜下血肿位置与颅骨形态的关系

Correlation of location of the chronic subdural hematoma and cranial morphology

目的探讨慢性硬膜下血肿(chronic subdural hematoma,CSDH)位置与枕部颅骨形态的关系。方法对98例经历CSDH手术患者的头颅CT/MRI影像进行回顾,对颅骨的对称性和CSDH的位置进行分析。结果患者平均(71.00±13.96)岁(37～93岁)。枕部颅骨对称患者37例,不对称61例。在不对称颅骨扁平位于右侧的有41例,位于左侧的有20例。CSDH为双侧患者20例,单侧78例,单侧血肿中30例位于右侧,48例位于左侧。双侧CSDH在枕部颅骨对称者较不对称者更为普遍,差异具有统计学意义(P=0.021)。在61例枕部颅骨不对称者中,CSDH双侧8例,在其余的53例患者中,CS-DH位于枕部颅骨扁平对侧的有37例,而位于扁平同侧的有16例。结论双侧CSDH常发生在枕部颅骨对称的患者,而在枕部颅骨不对称的患者,CSDH通常位于枕部颅骨扁平侧的对侧。

Objective To evaluate the relationship between occipital cranial morphology and location of chronic subdural hematoma（CSDH）.Methods The computed tomographic scans（CT） or magnetic resonance images（MRI） of 98 consecutive patients who underwent surgery for CSDH in the Air Force General Hospital of PLA between January 2002 and April 2012 were re-evaluated,and the symmetry of the occipital cranial vault,and the location of the CSDH were all checked.Results The mean age of the patients was 71.00±13.96 years（age range,37-93 years）.The occipital cranial vault was symmetrical in 37 patients（37.8%） and asymmetrical in 61 patients（62.2%）.The asymmetric crania were flat on the right side in 41 patients,on the left side in 20 patients.CSDH was bilateral in 20 patients（20.4%） and unilateral in 78 patients（79.6%）,and the unilateral hematomas were located on the right side in 30 patients and on the left side in 48 patients.It was more commonly bilateral in patients with a symmetrical occipital skull vault than those with an asymmetrical one and this difference was statistically significant（P=0.021）.In 61 patients with an asymmetric occipital cranial vault,the CSDH was bilateral in 8 patients.In the remaining 53 patients,the CSDH located on the opposite side of the flat side in 37 patients,and located on the same side of the flat side in 16 patients.Conclusions Bilateral CSDH is common in patients with symmetrical occipital cranial vault.In asymmetrical occipital cranial vault,CSDH is usually located on the opposite to the flat side of the skull.